| Np Family Medical Clinic | |
|
2300 24th Ave Gulfport MS 39501 | |
| (228) 206-6500 | |
| (866) 659-9359 |
| Full Name | Np Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2300 24th Ave, Gulfport, Mississippi |
| Authorized Official Name and Position | Carricka Thomas (NURSE PRACTITIONER) |
| Authorized Official Contact | 2283269951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Np Family Medical Clinic 2300 24th Ave Gulfport MS 39501-4605 Ph: (228) 206-6500 | Np Family Medical Clinic 2300 24th Ave Gulfport MS 39501 Ph: (228) 206-6500 |
| NPI Number | 1255713889 |
|---|---|
| Provider Enumeration Date | 06/19/2015 |
| Last Update Date | 01/15/2022 |
| Medicare PECOS PAC ID | 0042515009 |
|---|---|
| Medicare Enrollment ID | O20160229002693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255713889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Carricka Cartrica D Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538469689 PECOS PAC ID: 5294919064 Enrollment ID: I20110404000369 |
| Provider Name | Charlaysha Symone Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225685381 PECOS PAC ID: 0345571246 Enrollment ID: I20191008000140 |
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