Ms Kim Willams Truesdale, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Brooksville, Mississippi. Her current practice location is
139 North Oliver St, Brooksville, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 738-4424.
Ms Kim Willams Truesdale is licensed to practice in Mississippi (license number R576972) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609949692.
Provider's Profile
| Full Name | Ms Kim Willams Truesdale |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 139 North Oliver St, Brooksville, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1609949692
- Provider Enumeration Date: 11/16/2006
- Last Update Date: 12/01/2009
Medicare PECOS Information:
- PECOS PAC ID: 0840369161
- Enrollment ID: I20080513000327
Medical Identifiers
Medical identifiers for Ms Kim Willams Truesdale such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609949692 | NPI | - | NPPES |
| 00113993 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | R576972 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kim Willams Truesdale allows following entities to bill medicare on her behalf.
| Entity Name | Oktibbeha County Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124144381
PECOS PAC ID: 4587653993
Enrollment ID: O20040511000423 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kim Willams Truesdale is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Kim Willams Truesdale, CRNP
6637 Greenfield Dr,
West Point, MS 39773-6501
Ph: (662) 492-4307 | Ms Kim Willams Truesdale, CRNP
139 North Oliver St,
Brooksville, MS 39739
Ph: (662) 738-4424 |
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