Tara Puckett, NP-C | |
423 Central Ave, Coldwater, MS 38618-3915 | |
(662) 622-7011 | |
Not Available |
Full Name | Tara Puckett |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 423 Central Ave, Coldwater, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942695929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | R880191 (Mississippi) | Primary |
Entity Name | Clinic 221 Family Health Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073089843 PECOS PAC ID: 4880938992 Enrollment ID: O20181130000540 |
Mailing Address | Practice Location Address |
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Tara Puckett, NP-C 400 Northwest Plz, Senatobia, MS 38668-1740 Ph: (662) 301-8330 | Tara Puckett, NP-C 423 Central Ave, Coldwater, MS 38618-3915 Ph: (662) 622-7011 |
Joseph Louis Omedeo Jr., NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 423 Central Ave, Coldwater, MS 38618 Phone: 662-622-7011 | |
Jamie Birge, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 643 W Service Dr, Coldwater, MS 38618 Phone: 662-624-4292 Fax: 662-624-4354 | |
Kasey Maria Rowley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 431 Central Ave, Coldwater, MS 38618 Phone: 662-622-7011 | |
Anthony Newson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 643 W Service Dr, Coldwater, MS 38618 Phone: 662-233-5200 Fax: 662-624-4354 | |
Blake Andrew Embrey, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 423 Central Avenue, Coldwater, MS 38618 Phone: 662-622-7011 | |
Natalie H Barker, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4962 Highway 305, Coldwater, MS 38618 Phone: 662-370-5067 Fax: 662-370-5076 |