PAULA DECANTER (NPI# 1750351540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750351540 |
Entity Type | Individual |
Full Name | PAULA DECANTER |
Credential | FNP |
Practice Address |
1755 County Road 81 Blue Mountain MS 38610-9657 |
Practice Telephone | 6625384111 |
Practice Fax Number | 6625384128 |
Mailing Telephone | 6625384111 |
Mailing Fax Number | 6625384128 |
Enumeration Date | 2006-01-24 |
Last Update Date | 2013-10-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R819565 | MS | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 0121560 | 05 |
Street Address |
1755 COUNTY ROAD 81 |
City | BLUE MOUNTAIN |
State | MS |
Zip Code | 38610-9657 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306236617 | Donna Cannon | Nurse Practitioner | 1755 County Road 81, Blue Mountain, MS 38610-9657 | 2015-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770050908 | Thompson Medical Service, LLC | General Practice | 1200 Hwy 15 North, Blue Mountain, MS 38610 | 2018-10-25 |
1235113069 | Blue Mountain Family Medicine Clinic | Clinic/Center | 124 North Guyton, Blue Mountain, MS 38610 | 2005-12-05 |
1578841037 | Blue Mountain Family Practice Clinic | Family Medicine | 124 Guyton Blvd, Blue Mountain, MS 38610-8834 | 2011-08-01 |
1023566882 | Meagan Childs | Speech-Language Pathologist | 621 Highway 15, Blue Mountain, MS 38610-8842 | 2016-09-21 |
1548738610 | Amanda Marie Allison | Specialist/Technologist | 201 W Main St, Blue Mountain, MS 38610-9220 | 2018-11-07 |
1215948047 | Phyllis Gail Koonce | Nurse Practitioner | 100 County Road 714, Blue Mountain, MS 38610-9743 | 2006-08-10 |
1447596325 | Cotton Plant Clinic | Clinic/Center | 100 County Road 714, Blue Mountain, MS 38610-9743 | 2012-12-20 |
1891074779 | Family Clinic of Cotton Plant, LLC | Clinic/Center | 100 County Road 714, Blue Mountain, MS 38610-9743 | 2011-08-10 |
1891911186 | Phyllis G Koonce | Clinic/Center | 100 County Road 714, Blue Mountain, MS 38610-9743 | 2007-04-17 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215948047 | Phyllis Gail Koonce | Nurse Practitioner | 100 County Road 714, Blue Mountain, MS 38610-9743 | 2006-08-10 |
1306236617 | Donna Cannon | Nurse Practitioner | 1755 County Road 81, Blue Mountain, MS 38610-9657 | 2015-01-26 |
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 | BLUE MOUNTAIN |
Zip Code | 38610 |
Please comment or provide details below to improve the information on PAULA DECANTER.
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.