PRIMESOURCE NURSING SERVICES, INC (NPI# 1801987870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801987870 |
| Entity Type | Organization |
| Organization Name | PRIMESOURCE NURSING SERVICES, INC |
| Practice Address |
4906 Kendall Ave Gulfport MS 39507-4409 |
| Mailing Address |
Po Box 6705 Gulfport MS 39506-6705 |
| Practice Telephone | 2288651330 |
| Practice Fax Number | 2288651331 |
| Mailing Telephone | 2288651330 |
| Mailing Fax Number | 2288651331 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JANA LEIGH PLAUCHE (PRESIDENT) |
| Authorized Official Telephone | 2288651330 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06550237 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114583994 | Primesource Nursing Services, Inc | Nurse Practitioner | 2279 Atkinson Rd, Biloxi, MS 39531-2209 | 2019-05-16 |
| 1952884652 | Primesource Nursing Services, Inc | Social Worker | 1500 Broad Ave, Gulfport, MS 39501-3601 | 2018-09-10 |
| 1962573170 | Primesource Nursing Services, Inc | Social Worker | 38 Pass Rd Ste A, Gulfport, MS 39507-3107 | 2006-11-10 |
| Street Address |
4906 KENDALL AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507-4409 |
| 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 | 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 |
|---|---|---|---|---|
| 1356960777 | Jennifer M Hunter | Nurse Practitioner | 8970 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-04-15 |
| 1831720242 | Amanda R Woodcock | Nurse Practitioner | 1391 Broad Ave Ste A, Gulfport, MS 39501-2419 | 2020-02-04 |
| 1528428182 | Teresa Kay Guy | Nurse Practitioner | 6107 Kipps Colony Dr W, Gulfport, FL 33707-3969 | 2016-02-25 |
| 1255608816 | 828 Walk In Clinic | Nurse Practitioner | 12207 Hwy 49, Suite 40, Gulfport, MS 39503 | 2011-11-28 |
| 1326343484 | Kelli Michelle Garrigues | Nurse Practitioner | 1110 Broad Ave Ste 700, Gulfport, MS 39501-8908 | 2011-01-21 |
| 1386815694 | Heather Nicole Swann | Nurse Practitioner | 4333 15th St Ste B, Gulfport, MS 39501 | 2008-03-13 |
| 1013064245 | Leigh P Drace | Nurse Practitioner | 394 Courthouse Rd Ste A, Gulfport, MS 39507-1866 | 2007-01-03 |
| 1659477693 | Gary Dalton Gentry | Nurse Practitioner | 4500 13th Street, Wound Care, Gulfport, MS 39501 | 2006-09-16 |
| 1487673406 | Katherine P Griffis | Nurse Practitioner | 38 Pass Rd Ste A, Gulfport, MS 39507-3107 | 2006-07-19 |
| 1982671921 | Karen Rimanich Boudreaux | Nurse Practitioner | 15024 Martin Luther King Jr. Blvd., Gulfport, MS 39501-8306 | 2006-03-08 |
| 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.