| Leita N Stark, FNP-BC | |
|
5500 Highway 363, Mantachie, MS 38855-7197 | |
| (662) 282-4226 | |
| Not Available |
| Full Name | Leita N Stark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 15 Years |
| Location | 5500 Highway 363, Mantachie, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760719447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R862379 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Mississippi Medical Ctr Hha | Tupelo, MS | Home health agency |
| North Mississippi Medical Center | Tupelo, MS | Hospital |
| North Mississippi Medical Center-gilmore Amory | Amory, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Mississippi Medical Clinics Inc | 6103736665 | 114 |
| Entity Name | North Mississippi Medical Clinics Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053469486 PECOS PAC ID: 6103736665 Enrollment ID: O20040127000582 |
| Mailing Address | Practice Location Address |
|---|---|
| Leita N Stark, FNP-BC 95 Ivie Ln, Mantachie, MS 38855-8383 Ph: (662) 322-3278 | Leita N Stark, FNP-BC 5500 Highway 363, Mantachie, MS 38855-7197 Ph: (662) 282-4226 |
Ms. Bonnie Renee' Jones, MSN, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 285 Ivie Ln, Mantachie, MS 38855 Phone: 662-282-4197 Fax: 662-282-5121 | |
Madison Leigh Carrell, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5681 Ms-363, Mantachie, MS 38855 Phone: 662-282-4226 | |
Austin Harbor Black, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5681 Highway 363, Mantachie, MS 38855 Phone: 662-282-4226 | |
Susan Long Newell, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3275 Highway 371 N, Mantachie, MS 38855 Phone: 662-282-7555 | |
Nativel J Collins, CFNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3275 Highway 371 N, Mantachie, MS 38855 Phone: 662-282-7555 Fax: 877-254-0552 | |
Crystal Jo Nichols, C.F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 285 Ivie Ln, Mantachie, MS 38855 Phone: 662-282-4197 Fax: 662-282-5121 | |
Amy Lynn Floyd, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5681 Highway 363, Mantachie, MS 38855 Phone: 662-282-4226 Fax: 662-282-7946 |