JEANNIE D PENCE (NPI# 1063637106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063637106 |
| Entity Type | Individual |
| Full Name | JEANNIE D PENCE |
| Credential | CANP |
| Practice Address |
1542 Medical Park Cir Tupelo MS 38801-6560 |
| Practice Telephone | 6628444711 |
| Practice Fax Number | 6628449619 |
| Mailing Telephone | 6628444711 |
| Mailing Fax Number | 6628449619 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R682519 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1542 MEDICAL PARK CIR |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649240599 | Morris R Hamilton | Internal Medicine | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2006-01-24 |
| 1972971679 | Renal Care Group Tupelo LLC | Clinic/Center | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2015-09-11 |
| 1487020806 | Amita Maibam | Internal Medicine | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2015-08-19 |
| 1851657126 | Renal Care Group Tupelo, LLC | Clinic/Center | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2012-04-11 |
| 1134427719 | Harminder K Atwal | Nurse Practitioner | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2011-03-07 |
| 1972754034 | Patricia Mcknight | Nurse Practitioner | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2008-10-08 |
| 1184802704 | Nephrology and Hypertension Associates, Ltd | Internal Medicine | 1542 Medical Park Cir, 1542 Medical Park Circle, Tupelo, MS 38801-6560 | 2008-02-06 |
| 1497800833 | Shannon R Warren | Nurse Practitioner | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2007-01-24 |
| 1902975139 | Nephrology & Hypertension Associates, Ltd. | Internal Medicine | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2006-11-06 |
| 1437261260 | Renal Care Group Tupelo, LLC | Clinic/Center | 1542 Medical Park Cir, Tupelo, MS 38801-6560 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992177463 | Rhonda Von Strahl | Nurse Practitioner | 830 North Gloster St, Tupelo, MS 38801 | 2015-10-23 |
| 1902381775 | Stephanie Glover | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4996 | 2018-09-27 |
| 1396286209 | Toni Burnett | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2017-03-10 |
| 1760922462 | Carrington Campbell | Nurse Practitioner | 848 S Madison St, Tupelo, MS 38801-4905 | 2017-02-28 |
| 1598207912 | Julie Mccord | Nurse Practitioner | 830 S Gloster St, Tupelo, MS 38801-4934 | 2016-11-16 |
| 1104253699 | Ashley Carpenter Gilliland | Nurse Practitioner | 961 S Gloster St, Tupelo, MS 38801-6343 | 2013-09-30 |
| 1255775276 | Vicki Lynn Currie | Nurse Practitioner | 848 S Madison St, Tupelo, MS 38801-4905 | 2013-04-21 |
| 1649549858 | Vivian Ann Rogers | Nurse Practitioner | 408 Council Cir, Suite C, Tupelo, MS 38801-4949 | 2011-12-16 |
| 1689950040 | Lisa Dabbs | Nurse Practitioner | 845 S Madison St, Tupelo, MS 38801-4905 | 2011-10-31 |
| 1912963471 | Michelle Turba | Nurse Practitioner | 845 S Madison St, Tupelo, MS 38801-4905 | 2006-04-25 |
| Find all providers in TUPELO | ||||
Please comment or provide details below to improve the information on JEANNIE D PENCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.