MS. THERESA M MASSEY FNP - NPI 1225123086 - Nurse Practitioner in Iuka, MS

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

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About Ms. Theresa M Massey Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. THERESA M MASSEY FNP (NPI 1225123086) is an individual family provider in Iuka, Mississippi, licensed in Mississippi (R530581) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1225123086

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. THERESA M MASSEYCredential: FNP

Location Address1413 W QUITMAN STIuka, MS 38852-1130

Mailing Address1413 W Quitman StIuka, MS 38852-1130 · (662) 424-9550 · Fax (662) 424-9558

Phone(662) 424-9550

Fax(662) 424-9558

Sole ProprietorNo

Enumeration DateOctober 4, 2006

Last NPPES UpdateJanuary 21, 2016

✔ NPI 1225123086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · R530581

1413 W QUITMAN ST, Iuka, MS 38852

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Other Identifiers 2

Medicaid0125347MS

Medicare UPINR96383MS

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AVALON MEDICAL LLC

Family Medicine