| Jennifer Miranda Summers, NP-C | |
|
44 Brooklyn Janice Rd, Brooklyn, MS 39425-9731 | |
| (601) 582-1188 | |
| (601) 582-8844 |
| Full Name | Jennifer Miranda Summers |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 44 Brooklyn Janice Rd, Brooklyn, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225514391 | NPI | - | NPPES |
| 09734315 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 902797 (Mississippi) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 902797 (Mississippi) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeast Mississippi Rural Health Initiative, Inc | 2466342605 | 33 |
| Hattiesburg Clinic Pa | 5193706794 | 492 |
| Entity Name | Southeast Mississippi Rural Health Initiative, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184694036 PECOS PAC ID: 2466342605 Enrollment ID: O20040319000300 |
| 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 |
| Entity Name | Fast Pace Mississippi Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447769559 PECOS PAC ID: 3678832029 Enrollment ID: O20180111000291 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Miranda Summers, NP-C Po Box 1729, Hattiesburg, MS 39403-1729 Ph: (601) 545-8700 | Jennifer Miranda Summers, NP-C 44 Brooklyn Janice Rd, Brooklyn, MS 39425-9731 Ph: (601) 582-1188 |
Charles F Diamond, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 44 Brooklyn Janice Rd, Brooklyn, MS 39425 Phone: 601-582-1188 | |
Ms. Susan E Gentry, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 44 Brooklyn Janice Rd, Brooklyn, MS 39425 Phone: 601-582-1188 Fax: 601-582-8844 |