| Bettye Brinson Logan, FNP | |
|
704 S 5th St, Collins, MS 39428-4147 | |
| (601) 765-4414 | |
| (601) 765-9141 |
| Full Name | Bettye Brinson Logan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 704 S 5th St, Collins, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376504597 | NPI | - | NPPES |
| 00114365 | Medicaid | MS | |
| 7064459 | Other | MS | AETNA |
| 7923884 | Other | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | R623172 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 623172 (Mississippi) | Primary |
| Entity Name | Hattiesburg Clinic Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685 |
| Mailing Address | Practice Location Address |
|---|---|
| Bettye Brinson Logan, FNP 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 765-4414 | Bettye Brinson Logan, FNP 704 S 5th St, Collins, MS 39428-4147 Ph: (601) 765-4414 |
Mrs. Linda B Buffington, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-3180 Fax: 601-765-2808 | |
Terrie S Wilson, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 301 Hospital Blvd, Collins, Collins, MS 39428 Phone: 601-698-0328 Fax: 601-765-2808 | |
Charlie Crafton, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 | |
Shelby Slade Dickerson, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3275 Highway 49, Collins, MS 39428 Phone: 601-765-6292 | |
Mrs. Bria Goff, FNP-C, MPH Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 | |
Laura Jean Davis, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-3180 Fax: 601-765-2808 |