RANDAL HERBERT (NPI# 1356781819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356781819 |
| Entity Type | Individual |
| Full Name | RANDAL HERBERT |
| Other Name | RANDY HERBERT |
| Credential | FNP-C |
| Practice Address |
14116 Customs Blvd Gulfport MS 39503-5164 |
| Mailing Address |
4200 Iola St. Metairie LA 70001 |
| Practice Telephone | 6019576300 |
| Mailing Telephone | 5042960777 |
| Mailing Fax Number | 5044552992 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2019-10-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F0613731 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Galleria Blvd # 1420, Metairie, LA 700012082 | 8333625364 | |
| 1401 Foucher St, New Orleans, LA 701153515 | 5048978250 |
| Street Address |
14116 CUSTOMS BLVD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-5164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073551511 | Daniel Salmeron | Family Medicine | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2006-06-04 |
| 1013473610 | Corschika Henry Hart | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2019-02-19 |
| 1053818245 | Landmark Medical of Mississippi PC | General Practice | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2018-04-12 |
| 1396295382 | Bonnie Rosenthal | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2016-10-13 |
| 1295107357 | Tammy Vincent | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2015-10-28 |
| 1972984136 | Joanne Fairley | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2015-06-13 |
| 1952649774 | Jamie Robinson | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2013-01-29 |
| 1366616344 | Amber Martin Arnold | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2008-04-21 |
| 1811079544 | Debra B Baxter | Nurse Practitioner | 14116 Customs Blvd, Gulfport, MS 39503-5164 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1063033108 | Tiffany Reffit | Nurse Practitioner | 4300 15th St Ste B, Gulfport, MS 39501-2524 | 2020-04-29 |
| 1669002333 | Lauren Renee Meaut | Nurse Practitioner | 1391 Broad Ave Ste 320, Gulfport, MS 39501-2419 | 2020-01-22 |
| 1871132076 | Meddol Regina Mccray | Nurse Practitioner | 2070 30th St, Gulfport, MS 39501-6055 | 2020-01-06 |
| 1154968394 | Carolyn Marie Peters | Nurse Practitioner | 10236 Little Gem Dr, Gulfport, MS 39503-8357 | 2019-12-06 |
| 1588121578 | Mai Thi Tran | Nurse Practitioner | 1404 44th Ave, Gulfport, MS 39501-2554 | 2019-02-26 |
| 1861957631 | Tomika Marie Dedeaux | Nurse Practitioner | 283 Debuys Rd, Gulfport, MS 39507-2800 | 2019-02-06 |
| 1861963993 | Carol Leigh Anne Thompson | Nurse Practitioner | 2449 Summerwood, Gulfport, MS 39507-2216 | 2018-12-16 |
| 1730679739 | Erica Lynn Turan | Nurse Practitioner | 3310 17th St, Gulfport, MS 39501-3915 | 2018-05-15 |
| 1740709773 | Justine Hunt | Nurse Practitioner | 8950 Lorraine Rd Ste B, Gulfport, MS 39503-4183 | 2017-09-11 |
| Find all providers in GULFPORT | ||||
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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.