MR. KENNERH PROVINE COLLINS (NPI# 1982042198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982042198 |
| Entity Type | Individual |
| Full Name | MR. KENNERH PROVINE COLLINS |
| Credential | BS |
| Practice Address |
2917 56th Court Meridian MS 39305 |
| Practice Telephone | 6016049114 |
| Mailing Telephone | 6016049114 |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
E7052 | MS | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MISSISSIPPI PHARMACY LICENSE | E7052 | 01 |
| Street Address |
2917 56TH COURT |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521053 | Shirley Home Care, LLC | Nurse's Aide | 4525 Poplar Springs Drive, Meridian, MS 39305 | 2020-09-08 |
| 1871017855 | Robbyn Lee | Nurse Practitioner | 4715 24th Place, Meridian, MS 39305 | 2017-08-01 |
| 1245686575 | Synergy Physical Therapy & Sports Medicine, LLC | Clinic/Center | 2447 47th Court, Suite F, Meridian, MS 39305 | 2016-05-05 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1306284880 | A1 In Home Therapy | Community Health Worker | 211 North Hills Street J6, A1 In Home Therapy, Meridian, MS 39305 | 2013-06-06 |
| 1497192876 | Taylor Farland | Dentist | 2300 North Hills, Meridian, MS 39305 | 2013-05-27 |
| 1376814533 | Priscilla Miller | Nurse Practitioner | 4715 42nd Place, Meridian, MS 39305 | 2012-01-19 |
| 1497083927 | Kelley C Gowdy | Nurse Practitioner | 4711 Poplar Springs Drive, Meridian, MS 39305 | 2009-11-20 |
| 1578757076 | Primary Eyecare & Optical of Meridian, P.a. | Optometrist | 4721 26th Ave., Meridian, MS 39305 | 2007-08-29 |
| Find all providers in zip 39305 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041905 | Cory W Welch | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2019-12-21 |
| 1558909143 | Emily Mikaela Elwell | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6351 | 2019-12-14 |
| 1831473115 | Julie Kay Brown | Pharmacist | 3150 W Cherry Ln, Meridian, ID 83642-1122 | 2011-10-04 |
| 1013127547 | Audrey Gyung Nguyen | Pharmacist | 520 S Eagle Rd, Meridian, ID 83642-6308 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750898961 | Laquita L. Johnson | Pharmacist | 102 Williams Street, Hazlehurst, MS 39083 | 2018-01-09 |
| 1720445653 | Brooke F. Coffelt | Pharmacist | 1807 Edna Dr, Vicksburg, MS 39180-3724 | 2016-01-22 |
| 1871993972 | Thomas A Webb | Pharmacist | 1500 E Woodrow Wilson Ave # Slot119, Jackson, MS 39216-5116 | 2014-08-26 |
| 1184973737 | Stephen Caleb Williamson | Pharmacist | 801 Main Street, Collins, MS 39428 | 2012-08-29 |
| 1245515949 | An Duc Dang | Pharmacist | 405 Concord Dr, Clinton, MS 39056-5703 | 2011-10-14 |
| 1093986259 | Julie Searfoss George | Pharmacist | 350 West Woodrow Wilson Boulevard, Jackson, MS 39213 | 2008-03-17 |
| 1841411667 | James Albert Bennett | Pharmacist | 2049 Shiloh Rd, Corinth, MS 38834 | 2007-05-01 |
| 1275616831 | Ewell Spencer Hudson | Pharmacist | 108 N Court, Sumner, MS 38957-0526 | 2006-10-24 |
| 1801418843 | Jamie Wagner | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-05-13 |
| 1124666300 | Henderson Delmar Warnock IIi | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2019-12-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. KENNERH PROVINE COLLINS.
| 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.