MRS. DEERA WARREN (NPI# 1528558061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528558061 |
| Entity Type | Individual |
| Full Name | MRS. DEERA WARREN |
| Credential | MSN, FNP-C |
| Practice Address |
7601 Southcrest Pkwy Southaven MS 38671 |
| Mailing Address |
6576 Payne Ln Olive Branch MS 38654-9192 |
| Practice Telephone | 6627723260 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 902552 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F02180313 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7601 SOUTHCREST PKWY |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637090 | Cunningham Physical Medicine | Physical Medicine & Rehabilitation | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2005-05-24 |
| 1598395501 | Raymond Bennett Caldwell Iv | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2020-01-17 |
| 1245871847 | Tammy Q Reed | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2019-10-04 |
| 1871078436 | Catherine R Stepter | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-30 |
| 1669955423 | Tannisha Monique Loggins | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-07 |
| 1982185609 | Gloria S. Hicks | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-08-22 |
| 1326531229 | John Walker | Registered Nurse | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-06-14 |
| 1750871299 | Alejandro Polania | Physician Assistant | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1871083386 | Kenneth A Krzyzkowski | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1720575392 | Holly Jackson | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-04-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323461 | Lauren Elizabeth Boone | Nurse Practitioner | 3415 Shiloh Ln, Southaven, MS 38672-6045 | 2020-07-21 |
| 1558979229 | Adrianne Amanda Anderson | Nurse Practitioner | 8390 Ansley Park Ln, Southaven, MS 38672-8340 | 2020-07-20 |
| 1033765730 | Angela Oigbokie | Nurse Practitioner | 5833 Strawberry Pointe Cv, Southaven, MS 38672-6619 | 2019-08-18 |
| 1598124927 | Harmony Health, Pllc | Nurse Practitioner | 4744 We Ross Pkwy, Southaven, MS 38671-7169 | 2016-02-12 |
| 1891103313 | Connie Jean Hodge | Nurse Practitioner | 5699 Getwell Rd Ste 3, Southaven, MS 38672-7312 | 2014-07-28 |
| 1871728436 | Rena D Montgomery | Nurse Practitioner | 125 Guthrie Dr, Southaven, MS 38671-5829 | 2009-05-26 |
| 1669955423 | Tannisha Monique Loggins | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-09-07 |
| 1871083386 | Kenneth A Krzyzkowski | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-05-10 |
| 1700383007 | Aaron Douglas Smith | Nurse Practitioner | 7601 Southcrest Pkwy, Southaven, MS 38671 | 2018-04-12 |
| 1235653445 | Catherine Ruth Smith | Nurse Practitioner | 7362 Southcrest Pkwy, Southaven, MS 38671 | 2017-07-29 |
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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.