KENYATTA N MOORE (NPI# 1457633034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457633034 |
| Entity Type | Individual |
| Full Name | KENYATTA N MOORE |
| Credential | NP-C |
| Practice Address |
768 N Avery Blvd Ridgeland MS 39157-5219 |
| Practice Telephone | 6014876482 |
| Practice Fax Number | 6014876528 |
| Mailing Telephone | 6014876482 |
| Mailing Fax Number | 6014876528 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R871546 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
768 N AVERY BLVD |
| City | RIDGELAND |
| State | MS |
| Zip Code | 39157-5219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631023 | Mychell Thomas | Licensed Practical Nurse | 199 Charmant Place, Ridgeland, MS 39157 | 2020-08-28 |
| 1225680945 | Verthena Edwards | Home Health | 301 Pinehurst Cir, N/a, Ridgeland, MS 39157 | 2019-07-12 |
| 1730663469 | Essential Touchtones | Psychologist | 210 W. Jackson Street, Ridgeland, MS 39157 | 2018-09-19 |
| 1841786365 | Whitney Paige Crum | Speech-Language Pathologist | Laskin Therapy Group Pa, 207 W Jackson St, Ridgeland, MS 39157 | 2018-07-09 |
| 1811487002 | Camille Brockett | Social Worker | 270 Trace Colony Park Dr Ste B, Ridgeland, MS 39157 | 2018-05-14 |
| 1588171177 | Layson Counseling Group, Pllc | Counselor | 573 Hwy 51 Suite B, Ridgeland, MS 39157 | 2018-01-04 |
| 1407376452 | Mobility Rehab LLC | Clinic/Center | 745 S Pear Orchard Road, Apt 335, Ridgeland, MS 39157 | 2017-06-21 |
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1093263410 | Natural Health Project LLC | General Practice | 555 Highway 51, Ridgeland, MS 39157 | 2016-09-14 |
| 1851755714 | Jerlunda Lynn Dudley | Social Worker | 511 Clark Street, Rosedale, MS 39157 | 2016-04-07 |
| Find all providers in zip 39157 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195293 | Britney Sandifer | Nurse Practitioner | 297 Highway 51 Ste C, Ridgeland, MS 39157-3423 | 2020-02-11 |
| 1548820897 | Shannon Flood | Nurse Practitioner | 715 Rice Rd Apt 13a, Ridgeland, MS 39157-3009 | 2019-06-18 |
| 1639634751 | Grace Fairley Hampton | Nurse Practitioner | 715 Rice Rd, Ridgeland, MS 39157-3017 | 2019-02-02 |
| 1679086060 | Ankita Daya | Nurse Practitioner | 1000 Highland Colony Pkwy Ste 7205, Ridgeland, MS 39157-2099 | 2017-11-08 |
| 1265891386 | Bhjm LLC | Nurse Practitioner | 574 Highland Colony Pkwy, Suite 320-k, Ridgeland, MS 39157-6072 | 2016-02-17 |
| 1750779849 | Tiashia Rollins | Nurse Practitioner | 299 Highway 51 Ste F1, Ridgeland, MS 39157-3424 | 2014-12-26 |
| 1750720330 | Allison Ginette Jackson | Nurse Practitioner | 719 N Okatie Hwy # 170, Ridgeland, SC 29936-8276 | 2013-06-18 |
| 1265795678 | Dana Milling Germany | Nurse Practitioner | 101 W Washington St Ste C1, Ridgeland, MS 39157-2434 | 2012-06-20 |
| 1407114432 | Emmanuel Health Services | Nurse Practitioner | 637 Highway 51 North, Suite E, Ridgeland, MS 39157 | 2012-04-27 |
| 1790072288 | Rasheda K Jordan | Nurse Practitioner | 297 Hwy 51, Suite B, Ridgeland, MS 39157 | 2011-07-05 |
| Find all providers in RIDGELAND | ||||
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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.