THRISHANNA CLARK (NPI# 1356810360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356810360 |
Entity Type | Individual |
Full Name | THRISHANNA CLARK |
Credential | NP |
Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
Mailing Address |
115 Whippoorwill Rd Brandon MS 39047-6428 |
Practice Telephone | 6013625321 |
Mailing Telephone | 6016652953 |
Enumeration Date | 2018-11-19 |
Last Update Date | 2018-11-19 |
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 |
902942 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3502 W NORTHSIDE DR |
City | JACKSON |
State | MS |
Zip Code | 39213-4454 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
1952853731 | Beverly Carson Washington | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-10-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
Find all providers in zip 39213 |
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 |
---|---|---|---|---|
1912511981 | Nurture Mental Health & Wellness Center LLC | Nurse Practitioner | 125 S King St Ste 2a, Jackson, WY 83001-8124 | 2020-09-07 |
1811511819 | Aretha M. Northington | Nurse Practitioner | 1430 Wingfield Dr., Jackson, MS 39204-4448 | 2020-06-04 |
1760921225 | A Beautiful Mind LLC | Nurse Practitioner | 1856 Smallwood St, Jackson, MS 39212-2521 | 2017-02-16 |
1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
1114311446 | Lakeisha Crye Green | Nurse Practitioner | 5568 Tiki Ln, Jackson, MS 39212-3657 | 2015-03-25 |
1205176716 | Robert White LLC | Nurse Practitioner | 2290 West County Line Rd, Suite 105, Jackson, NEW JERSEY 08527 | 2013-02-20 |
1699046235 | Matrix Wellness Solutions | Nurse Practitioner | 384 Carriage House Dr Ste D, Suite D, Jackson, TN 38305-2268 | 2012-01-12 |
1063721314 | Anna M Cook | Nurse Practitioner | 163 W Univeristy Parkway, Jackson, TN 38305 | 2010-10-05 |
1720245848 | Carol Jeanne Dove | Nurse Practitioner | 4044 Briggs Ct, Jackson, MI 49201-9033 | 2008-05-16 |
1730203415 | Sherry M Blackford | Nurse Practitioner | 238 Summar Drive, Jackson, TN 38301 | 2007-03-19 |
Find all providers in JACKSON |
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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.