DELILAH MARIE BROCKUP (NPI# 1134777162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134777162 |
| Entity Type | Individual |
| Full Name | DELILAH MARIE BROCKUP |
| Practice Address |
4500 13th St Gulfport MS 39501-2515 |
| Mailing Address |
14231 Seaway Rd Gulfport MS 39503-4628 |
| Practice Telephone | 2288674000 |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043740608 | Core Neurodiagnostics, LLC | Specialist/Technologist, Other | 45 Hardy Court Ctr, #230, Gulfport, MS 39507-2501 | 2017-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212187 | Logan Palliser | Specialist/Technologist, Other | 728 Oakwood St, Jackson, MS 39202-1120 | 2020-10-12 |
| 1689026916 | Altamic Lewis | Specialist/Technologist, Other | 2046 Beach Blvd Apt D103, Biloxi, MS 39531-5125 | 2016-07-11 |
| 1841697026 | Southern Neuro Solutions | Specialist/Technologist, Other | 10216 3rd Ave Ste C, Diberville, MS 39540-2543 | 2014-12-03 |
| 1205114998 | Southern Monitoring Innovations LLC | Specialist/Technologist, Other | 17398 C J Dellie Rd, Saucier, MS 39574-8707 | 2011-07-28 |
| 1437296183 | Gary Kerr II | Specialist/Technologist, Other | 10216 3rd Ave, Suite C, Diberville, MS 39540-2544 | 2007-01-31 |
| 1346847274 | Devon Allred | Specialist/Technologist, Other | 1850 Chadwick Dr, Jackson, MS 39204-3404 | 2020-10-05 |
| 1437540275 | Southern Pro Read, LLC | Specialist/Technologist, Other | 10216 3rd Ave Ste C, Diberville, MS 39540-2543 | 2015-02-16 |
| 1245457662 | Christi Jo Cardwell | Specialist/Technologist, Other | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2007-04-19 |
Please comment or provide details below to improve the information on DELILAH MARIE BROCKUP.
| 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.