CARLA DIANE DIFFENDERFER (NPI# 1467880922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467880922 |
| Entity Type | Individual |
| Full Name | CARLA DIANE DIFFENDERFER |
| Credential | FNP |
| Practice Address |
11516 Lamey Bridge Rd Ste I Diberville MS 39540 |
| Mailing Address |
Po Box 1277 Biloxi MS 39533-1277 |
| Practice Telephone | 2282074190 |
| Practice Fax Number | 2282074156 |
| Mailing Telephone | 2282074190 |
| Mailing Fax Number | 2282074156 |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
901969 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
18523 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP2607 | 05 |
| Street Address |
11516 LAMEY BRIDGE RD STE I |
| City | DIBERVILLE |
| State | MS |
| Zip Code | 39540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689851479 | The Surgical Clinic | Family Medicine | 11516 Lamey Bridge Rd Ste I, Diberville, MS 39540-2725 | 2008-01-24 |
| 1568948016 | Courtney Leigh Ponder | Nurse Practitioner | 11516 Lamey Bridge Rd Ste I, Diberville, MS 39540 | 2018-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528347531 | Lindsey Rachelle Cuevas | Pharmacist | 10551 D'iberville Blvd, D'iberville, MS 39540 | 2011-08-08 |
| 1750438255 | Andrea L Davis | Dentist | 11505 Cinema Drive, Suite 6, D'iberville, MS 39540 | 2007-01-05 |
| 1750308250 | South Mississippi Urgent Care | Clinic/Center | 3661 Sangani Blvd, Suite E, Dlberville, MS 39540 | 2006-07-17 |
| 1134635360 | Southern Regional Chiropractic and Rehabilitation Center | Nurse Practitioner | 11505 Cinema Dr Ste 7, Diberville, MS 39540 | 2017-12-26 |
| 1487177481 | Walgreen Co | Pharmacy | 4031 Popps Ferry Rd Ste A, Diberville, MS 39540 | 2017-07-21 |
| 1891151817 | Total Renal Care Inc | Clinic/Center | 3200 Mallett Rd, Ste F, Diberville, MS 39540 | 2016-01-06 |
| 1679944763 | Katelyn Elizabeth Martin | Behavioral Analyst | 4061 Suzanne Dr, Diberville, MS 39540 | 2015-10-14 |
| 1982618369 | Becky F Hollibaugh | Family Medicine | 3920 Promenade Pkwy, Biloxi, MS 39540 | 2006-07-28 |
| 1962029629 | Jessica Jensen | Counselor | 356 Ginger Dr. #7385, D'iberville, MS 39540-0003 | 2020-06-29 |
| 1811550916 | Melody Michelle Rogers | Physical Therapy Assistant | 4016 Cassimer Ave, Diberville, MS 39540-2309 | 2019-04-15 |
| Find all providers in zip 39540 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720550221 | Nhung Thi Le | Nurse Practitioner | 3915 River Trace Dr, Diberville, MS 39540-5556 | 2018-12-20 |
| 1689154890 | Kaela Tong | Nurse Practitioner | 3850 River Trace Dr, Diberville, MS 39540-5500 | 2018-08-16 |
| 1477824902 | Chelsey E Windham | Nurse Practitioner | 3920 Promenade Pkwy Ste A, Diberville, MS 39540-5368 | 2012-01-13 |
| 1366912529 | Carissa Bolden | Nurse Practitioner | 3446 Big Ridge Rd, Diberville, MS 39540-2421 | 2018-11-30 |
| 1568948016 | Courtney Leigh Ponder | Nurse Practitioner | 11516 Lamey Bridge Rd Ste I, Diberville, MS 39540 | 2018-07-18 |
| 1508317405 | Cayla Switzer | Nurse Practitioner | 11516 Lamey Bridge Rd, Ste 2, Diberville, MS 39540-2725 | 2016-10-17 |
| 1720483779 | Dianna Michelle Thomas | Nurse Practitioner | 3920 Promenade Pkwy Ste A, Diberville, MS 39540-5368 | 2014-11-01 |
| 1588790497 | Donna Marie Boyd | Nurse Practitioner | 3661 Sangani Blvd, Suite E, Diberville, MS 39540-8706 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
| City | DIBERVILLE |
| Zip Code | 39540 |
Please comment or provide details below to improve the information on CARLA DIANE DIFFENDERFER.
| 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.