DR. SHANNA AMISHA TOLBERT CRAVEN (NPI# 1205178241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205178241 |
Entity Type | Individual |
Full Name | DR. SHANNA AMISHA TOLBERT CRAVEN |
Credential | DNP, ACNP-C |
Practice Address |
501 Marshall St Ste 104 Jackson MS 39202-1663 |
Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
Practice Telephone | 6019696404 |
Practice Fax Number | 6019734541 |
Mailing Fax Number | 9012278591 |
Enumeration Date | 2013-03-16 |
Last Update Date | 2020-01-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R877592 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
501 Marshall St Ste 104, Jackson, MS 392021663 | 6019696404 | 6019734541 |
Street Address |
501 MARSHALL ST STE 104 |
City | JACKSON |
State | MS |
Zip Code | 39202-1663 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578557013 | Frank Nelson Haugland | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2005-09-09 |
1760956247 | Siera Cheyenne Shiyou | Physician Assistant | 501 Marshall St Ste 104, Jackson, MS 39202 | 2019-01-17 |
1346751195 | Amy Wall | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2017-10-19 |
1578946612 | Katherine Tucker | Physician Assistant | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2015-07-07 |
1811396971 | Rachel P Hearst | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2014-08-14 |
1902235583 | Judith Stallings | Nurse Practitioner | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-11-05 |
1508206913 | Stephen David Anderson | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2013-06-28 |
1275897670 | Patrick Ross Thurmond | Internal Medicine | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-06-29 |
1275893638 | Derek Paul De Grijs | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2012-05-20 |
1215249016 | Rishi Ashok Roy | Surgery | 501 Marshall St Ste 104, Jackson, MS 39202-1663 | 2010-07-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
Find all providers in zip 39202 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700240397 | Veronique Monique Lynch | Nurse Practitioner | 963 Toms River Rd, Jackson, NJ 08527-5239 | 2016-04-08 |
1821423484 | Katherine G Lott | Nurse Practitioner | 6295 Old Canton Rd, Apt 23b, Jackson, MS 39211-2908 | 2013-09-13 |
1760618292 | Matthew Edward Flynn | Nurse Practitioner | 971 Lakeland Dr Ste 1052, Jackson, MS 39216-4609 | 2009-06-10 |
1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
1437785508 | Katey Andrews | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-03-20 |
1144854498 | Katlyn Amason | Nurse Practitioner | 501 Marshall St Ste 200, Jackson, MS 39202-1687 | 2020-02-25 |
1194364554 | Erica L Hawkins | Nurse Practitioner | 900 Cooper St, Jackson, MI 49202-3398 | 2020-01-03 |
1023664430 | Jennifer Elizabeth Overton | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2019-08-12 |
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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.