MS. SANDRA KINNAN (NPI# 1093722662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093722662 |
| Entity Type | Individual |
| Full Name | MS. SANDRA KINNAN |
| Credential | N.P. |
| Practice Address |
103 S 19th Ave Hattiesburg MS 39401-6171 |
| Mailing Address |
Po Box 1030 Hattiesburg MS 39403-1030 |
| Practice Telephone | 6015444641 |
| Practice Fax Number | 6015844053 |
| Mailing Telephone | 6015444641 |
| Mailing Fax Number | 6015844053 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R722863 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04535271 | 05 |
| Street Address |
103 S 19TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-6171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982610572 | Region 12 Commission On Mental Health & Retardation Pine Belt Men | Clinic/Center | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2006-08-01 |
| 1780199935 | Christine Boehmer | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-12-11 |
| 1679084024 | Donald Allan Dearman | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-10-12 |
| 1750808176 | Jason Courtney | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-25 |
| 1780101105 | Raymond Wooten | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-25 |
| 1073039830 | Jessica Owens | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-14 |
| 1275057457 | Shalaunda Brown | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-31 |
| 1144744327 | Chyra Dixon | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-31 |
| 1376066910 | Pamela Griffith | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-25 |
| 1912420720 | Katelin Holmes | Social Worker | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215267018 | Rebecca B Hartzog | Nurse Practitioner | 1 Lincoln Pkwy Ste 304, Hattiesburg, MS 39402-3261 | 2009-12-30 |
| 1679624696 | Diann Branton Mayfield | Nurse Practitioner | 2 Southern Point Pkwy, Suite 200, Hattiesburg, MS 39401-8025 | 2007-01-16 |
| 1275186850 | Erika Lytice Newsome | Nurse Practitioner | 1 Lincoln Pkwy Ste 304, Hattiesburg, MS 39402-3261 | 2019-07-22 |
| 1679084024 | Donald Allan Dearman | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-10-12 |
| 1538693510 | William Smith Turner Jr. | Nurse Practitioner | 2255 Broadway Dr, Hattiesburg, MS 39402-3254 | 2017-04-17 |
| 1174068076 | Racheal Marie Pritchett | Nurse Practitioner | 101 Aldersgate Cir, Hattiesburg, MS 39402-1301 | 2016-12-31 |
| 1346691714 | Billy J Thornton | Nurse Practitioner | 1 Lincoln Pkwy, Suite 202, Hattiesburg, MS 39402-3262 | 2016-06-28 |
| 1386930477 | Karen Lee | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2011-06-27 |
| 1346284130 | Patricia Calabrese | Nurse Practitioner | 1 Lincoln Parkway, Suite 202, Hattiesburg, MS 39402 | 2006-06-15 |
| 1194768242 | Richard Wayne George | Nurse Practitioner | 1 Lincoln Parkway, Suite 202, Hattiesburg, MS 39402 | 2006-06-14 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on MS. SANDRA KINNAN.
| 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.