| Bradley Keith Shields, | |
|
128 Earl Clark Dr, Florence, MS 39073-6604 | |
| (601) 891-8465 | |
| (601) 891-8468 |
| Full Name | Bradley Keith Shields |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 128 Earl Clark Dr, Florence, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073086005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 903096 (Mississippi) | Primary |
| Entity Name | South Rankin Family Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629143334 PECOS PAC ID: 2567463862 Enrollment ID: O20070130000340 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Keith Shields, 128 Earl Clark Dr, Florence, MS 39073-6604 Ph: (601) 891-8465 | Bradley Keith Shields, 128 Earl Clark Dr, Florence, MS 39073-6604 Ph: (601) 891-8465 |
Laurie Robinson, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 218 E Main St, Florence, MS 39073 Phone: 601-845-6602 Fax: 601-845-6164 | |
Abbey Ross, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Pierce Rd, Florence, MS 39073 Phone: 601-665-5999 | |
Tina Chandler, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 125 Earl Clark Dr, Florence, MS 39073 Phone: 601-891-8657 Fax: 949-561-5551 | |
April Melanie Sylvia, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 404 Copper Ridge Dr, Florence, MS 39073 Phone: 601-421-1120 | |
Margo Wilson Garrett, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 218 E Main St, Florence, MS 39073 Phone: 601-845-6602 Fax: 601-845-6164 | |
Katelyn Jo Buckley, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 171 Oak Hill Dr, Florence, MS 39073 Phone: 601-573-6297 |