MRS. AMANDA RENIA MIZELL (NPI# 1679896575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679896575 |
Entity Type | Individual |
Full Name | MRS. AMANDA RENIA MIZELL |
Credential | CRNP |
Practice Address |
1212 E Pass Rd Gulfport MS 39507-3403 |
Practice Telephone | 2288967108 |
Practice Fax Number | 2288967174 |
Mailing Telephone | 2288967108 |
Mailing Fax Number | 2288967174 |
Enumeration Date | 2010-03-05 |
Last Update Date | 2013-05-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R880871 | MS | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295243947 | Amanda Mizell | Registered Nurse | 1 Barnes Jew Hosp Plz, Saint Louis, MO 63110-1003 | 2018-01-16 |
Street Address |
1212 E PASS RD |
City | GULFPORT |
State | MS |
Zip Code | 39507-3403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457986564 | Alisa M Stephens | Nurse Practitioner | 1212 E Pass Rd, Gulfport, MS 39507-3403 | 2020-03-09 |
1144582040 | A R Mizell LLC | Nurse Practitioner | 1212 E Pass Rd, Gulfport, MS 39507-3403 | 2012-06-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
Find all providers in zip 39507 |
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.