PRINCESS MERRITT (NPI# 1912474735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912474735 |
| Entity Type | Individual |
| Full Name | PRINCESS MERRITT |
| Credential | LPN |
| Practice Address |
2434 S Eason Blvd Tupelo MS 38804-6942 |
| Practice Telephone | 6626404595 |
| Practice Fax Number | 6626806416 |
| Mailing Telephone | 6626404595 |
| Mailing Fax Number | 6626806416 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 325981 | MS | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018203 | 05 |
| Street Address |
2434 S EASON BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-6942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508893074 | Ross E Collins Jr. | Psychiatry & Neurology | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2006-06-28 |
| 1245831551 | Lisa Roberts | Registered Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1295336519 | Kyra Neal | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-11-03 |
| 1124635354 | Kecia Williams | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-10-01 |
| 1144837675 | Daniele Nolan | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1639786163 | Reagan Bartley | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-29 |
| 1033725056 | Moesha Banks | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1891301719 | Makinley Neighbors | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1073129094 | Stephanie Johnson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
| 1275149197 | Hallie Goodson | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-09-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316323173 | Pamella Nicole Morrison | Licensed Practical Nurse | 2005 W Main St Ste 205, Tupelo, MS 38801-3214 | 2015-08-04 |
| 1285838276 | Ruthilay Pearson | Licensed Practical Nurse | 114 White Pine Lane, Tupelo, MS 38801-8693 | 2007-06-13 |
| 1376164459 | Amanda Keith | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-04-30 |
| 1447899588 | Audrey Mcdaniel | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2020-01-06 |
| 1730733023 | Lynne Rogers | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-07-25 |
| 1689231862 | Stephanie Calabro | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-05-23 |
| 1538626882 | Jennifer Cox | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-02-22 |
| 1245722693 | Kayla Jean Byrd | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2018-06-01 |
| 1073960308 | Jordan Ward | Licensed Practical Nurse | 499 Gloster Creek Vlg, Tupelo, MS 38801-4600 | 2016-05-17 |
| 1699122937 | Telisa Coggins | Licensed Practical Nurse | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2016-05-17 |
| Find all providers in TUPELO | ||||
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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.