DESIREE NORMAN (NPI# 1861898355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861898355 |
| Entity Type | Individual |
| Full Name | DESIREE NORMAN |
| Other Name | DESIREE PETERSON |
| Credential | NP |
| Practice Address |
11150 Highway 49 Mbh Outpatient Clinic Gulfport MS 39503-4110 |
| Practice Telephone | 2285751000 |
| Practice Fax Number | 2285752002 |
| Mailing Telephone | 2285751000 |
| Mailing Fax Number | 2285752002 |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2015-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R872705 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01858357 | 05 |
| Street Address |
11150 HIGHWAY 49 MBH OUTPATIENT CLINIC |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801819263 | Ibis D. Sigas | Psychiatry & Neurology | 11150 Highway 49, Gulfport, MS 39503-4110 | 2006-07-26 |
| 1336780527 | Mary Elizabeth Paul | Nurse Practitioner | 11150 Highway 49, Gulfport, MS 39503-4110 | 2019-09-30 |
| 1407336423 | Kelly Lynn Tinson | Nurse Practitioner | 11150 Highway 49, Gulfport, MS 39503-4110 | 2018-08-20 |
| 1750891792 | Tbd Acquisition II LLC | Psychiatric Hospital | 11150 Highway 49, Gulfport, MS 39503-4110 | 2017-10-04 |
| 1649685561 | Memorial Hospital @ Gulfport | Social Worker | 11150 Highway 49, Gulfport, MS 39503-4110 | 2014-06-30 |
| 1295056349 | Kimberly Underwood Morgan | Counselor | 11150 Highway 49, Gulfport, MS 39503-4110 | 2010-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1386193183 | Joannie Evans | Nurse Practitioner | 368 Courthouse Rd, Suite D, Gulfport, MS 39507-1856 | 2016-09-22 |
| 1306147947 | Richard Brown Ray Jr. | Nurse Practitioner | 3413 Washington Ave, Gulfport, MS 39507-3039 | 2010-11-13 |
| 1639220205 | Maureen Stanton | Nurse Practitioner | 33 39th Street, Gulfport, MS 39507 | 2007-01-12 |
| 1679581052 | Eileen A Powell | Nurse Practitioner | 15120 County Barn Rd, Gulf Coast Mental Health Center Csu Unit, Gulfport, MS 39503-1263 | 2006-08-03 |
| 1437784550 | Chantal Sullivan Aprn-bc Pllc | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-03-09 |
| 1740811280 | Chantal Sullivan | Nurse Practitioner | 8990 Lorraine Rd, Gulfport, MS 39503-4176 | 2020-02-03 |
| 1336780527 | Mary Elizabeth Paul | Nurse Practitioner | 11150 Highway 49, Gulfport, MS 39503-4110 | 2019-09-30 |
| 1457829202 | Art Behavioral Health, Pllc | Nurse Practitioner | 1403 43rd Ave, Gulfport, MS 39501-2545 | 2018-11-09 |
| 1992270995 | Julie K Martin, Pmhnp-bc, LLC | Nurse Practitioner | 1403 43rd Ave, Gulfport, MS 39501-2545 | 2018-10-05 |
| 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.