Shanika Boyd, | |
130 N High St, Shubuta, MS 39360-8870 | |
(601) 687-1391 | |
(601) 687-0051 |
Full Name | Shanika Boyd |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Gerontology |
Location | 130 N High St, Shubuta, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578920328 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LG0600X | Nurse Practitioner - Gerontology | R878997 (Mississippi) | Primary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 878997 (Mississippi) | Secondary |
Entity Name | Outreach Health Services,inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548359565 PECOS PAC ID: 1951386911 Enrollment ID: O20040623000333 |
Entity Name | Community Care Health Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210520000556 |
Mailing Address | Practice Location Address |
---|---|
Shanika Boyd, 130 N High St, Shubuta, MS 39360-8870 Ph: (601) 687-1391 | Shanika Boyd, 130 N High St, Shubuta, MS 39360-8870 Ph: (601) 687-1391 |
Mrs. Virgie C Wade, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 130 North High St, Shubuta, MS 39360 Phone: 601-687-1391 Fax: 601-687-0051 | |
Mr. Robert William Dycus, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 130 N. High Street, Shubuta, MS 39360 Phone: 601-687-1391 | |
Patricia Simpson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 130 N High St, Shubuta, MS 39360 Phone: 601-687-1391 | |
Karen Parker, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 130n High St, Shubuta, MS 39360 Phone: 601-687-1391 Fax: 601-687-0051 | |
Chasity Michelle Sisson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 130 N High St, Shubuta, MS 39360 Phone: 601-687-1391 |