Shakita Diane Rawls, NURSE PRACTITIONER | |
1171 Columbia Purvis, Columbia, MS 39429-2059 | |
(601) 633-5226 | |
Not Available |
Full Name | Shakita Diane Rawls |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1171 Columbia Purvis, Columbia, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275043127 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 892142 (Mississippi) | Secondary |
363LF0000X | Nurse Practitioner - Family | 902365 (Mississippi) | Primary |
Entity Name | Quality Medical Clinic, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720497936 PECOS PAC ID: 4688998172 Enrollment ID: O20150109000472 |
Entity Name | Ultra Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922469543 PECOS PAC ID: 6800186602 Enrollment ID: O20190906001744 |
Entity Name | Progressive Medical Management Of Batesville Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700349222 PECOS PAC ID: 0345583225 Enrollment ID: O20191114002265 |
Mailing Address | Practice Location Address |
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Shakita Diane Rawls, NURSE PRACTITIONER 1171 Columbia Purvis, Columbia, MS 39429-2059 Ph: () - | Shakita Diane Rawls, NURSE PRACTITIONER 1171 Columbia Purvis, Columbia, MS 39429-2059 Ph: (601) 633-5226 |
Reanna Henderson, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 628 Main St, Columbia, MS 39429 Phone: 601-736-6877 | |
Alicia Brister, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 914 Sumrall Rd, Columbia, MS 39429 Phone: 601-731-1470 Fax: 601-731-1474 | |
Mrs. Marquita Tucker, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1050 Highway 98 Byp, Columbia, MS 39429 Phone: 601-522-2095 | |
Allison Patterson, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1560 Sumrall Rd, Columbia, MS 39429 Phone: 601-261-2940 | |
Lauren Hurst, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1560 Sumrall Rd, Columbia, MS 39429 Phone: 601-736-6303 | |
Brenda K Thornhill, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 912 Sumrall Rd, Columbia, MS 39429 Phone: 601-736-6443 Fax: 601-736-2543 | |
Ms. Ronda M. Vanderheiden, F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1560 Sumrall Rd, Columbia, MS 39429 Phone: 601-261-2940 Fax: 601-261-2942 |