| Primesource Nursing Services, Inc | |
|
38 Pass Rd Ste A Gulfport MS 39507-3107 | |
| (228) 865-1330 | |
| (228) 865-1331 |
| Full Name | Primesource Nursing Services, Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 38 Pass Rd Ste A, Gulfport, Mississippi |
| Authorized Official Name and Position | Rhett M Plauche (PRESIDENT) |
| Authorized Official Contact | 2288651330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primesource Nursing Services, Inc Po Box 6705 Gulfport MS 39506-6705 Ph: (228) 865-1330 | Primesource Nursing Services, Inc 38 Pass Rd Ste A Gulfport MS 39507-3107 Ph: (228) 865-1330 |
| NPI Number | 1962573170 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 04/02/2018 |
| Medicare PECOS PAC ID | 7113966037 |
|---|---|
| Medicare Enrollment ID | O20050429000745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962573170 | NPI | - | NPPES |
| 06550237 | Medicaid | MS |
| Provider Name | Gayle E Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578587523 PECOS PAC ID: 6406863794 Enrollment ID: I20060310000533 |
| Provider Name | Lucy B Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639331994 PECOS PAC ID: 1355403452 Enrollment ID: I20081226000146 |
| Provider Name | Jennifer S Brechtel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649370503 PECOS PAC ID: 9638179435 Enrollment ID: I20100510000251 |
| Provider Name | Phillip D Compton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578591186 PECOS PAC ID: 3476631458 Enrollment ID: I20100730000286 |
| Provider Name | Colleen Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922559012 PECOS PAC ID: 8123395944 Enrollment ID: I20170530000368 |
| Provider Name | Kelly L Tinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407336423 PECOS PAC ID: 5294089900 Enrollment ID: I20181115002895 |
| Provider Name | Hannah Leigh Fore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114481488 PECOS PAC ID: 2466785944 Enrollment ID: I20190617000413 |
| Provider Name | Lauren R Meaut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669002333 PECOS PAC ID: 4486084597 Enrollment ID: I20200413003056 |
| Provider Name | Jennifer Galle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073747564 PECOS PAC ID: 9234560293 Enrollment ID: I20200507002858 |
| Provider Name | Jeri Hughes Squyres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538107164 PECOS PAC ID: 1658748538 Enrollment ID: I20221107000096 |
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