PREMIER FAMILY AND URGENT CARE (NPI# 1104383389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104383389 |
| Entity Type | Organization |
| Organization Name | PREMIER FAMILY AND URGENT CARE |
| Practice Address |
2394 Mccullough Blvd Belden MS 38826-9579 |
| Practice Telephone | 6220530236 |
| Practice Fax Number | 8444659102 |
| Mailing Telephone | 6622691774 |
| Mailing Fax Number | 8444659102 |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | JESSICA HICKS-ROBERTSON (OWNER) |
| Authorized Official Telephone | 6628404577 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03403770 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1900 Mccullough Blvd, Suite C, Tupelo, MS 38801 | 6628404577 | 6628404594 |
| Street Address |
2394 MCCULLOUGH BLVD |
| City | BELDEN |
| State | MS |
| Zip Code | 38826-9579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912374174 | Ashli Kovalick | Nurse Practitioner | 2394 Mccullough Blvd, Belden, MS 38826-9579 | 2015-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457907248 | Tanya Sanderson | Nurse Practitioner | 4208 Ridgemont Drive, Belden, MS 38826 | 2019-08-16 |
| 1285085092 | Rhea Brown | Specialist/Technologist | 128 Brandywine Rd, Belden, MS 38826 | 2016-06-23 |
| 1265445472 | Rebecca Butler | Nurse Practitioner | 2885 Mccullough Blvd, Belden, MS 38826 | 2006-08-15 |
| 1679800841 | Express Care West, LLC | Clinic/Center | 2885 Mccullough Blvd, Belden, MS 38826 | 2009-11-10 |
| 1215186028 | James L Burrell Jr. | Nurse Practitioner | 2885 Mccullough Blvd, Belden, MS 38826 | 2008-09-17 |
| 1750318150 | Beneficial Pharmaceutical Supply LLC | Pharmacy | 2445 Mccullough Blvd, Belden, MS 38826 | 2006-06-28 |
| 1023324944 | Christopher Morris Weaver | Contractor | 1700 Thicket Cv, Belden, MS 38826-6008 | 2010-08-30 |
| 1922315761 | Carla Quinn Weaver | Speech-Language Pathologist | 1700 Thicket Cv, Belden, MS 38826-6008 | 2010-08-31 |
| 1124359229 | Rachel Lorraine Staten | Nurse Practitioner | 112 Grand Ole Oaks Dr, Apt # 2, Belden, MS 38826-7014 | 2010-01-29 |
| 1124471131 | 1st Step Medical PC | Family Medicine | 3104 Adams Farm Rd, Belden, MS 38826-7020 | 2016-07-14 |
| Find all providers in zip 38826 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265445472 | Rebecca Butler | Nurse Practitioner | 2885 Mccullough Blvd, Belden, MS 38826 | 2006-08-15 |
| 1750795886 | Joy Hardin Cleveland | Nurse Practitioner | 2885 Mccullough Blvd, Ste A, Belden, MS 38826-9001 | 2014-06-17 |
| 1215186028 | James L Burrell Jr. | Nurse Practitioner | 2885 Mccullough Blvd, Belden, MS 38826 | 2008-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| 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.