Mrs Latasha Jackson Claiborne, PMHNP in Vicksburg, MS

Mrs Latasha Jackson Claiborne, PMHNP is a medicare enrolled "Registered Nurse" in Vicksburg, Mississippi. Her current practice location is 3444 Wisconsin Ave, Vicksburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 638-0031.

Mrs Latasha Jackson Claiborne is licensed to practice in Mississippi (license number 163W00000X) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104104413.

Contact Information

	Mrs Latasha Jackson Claiborne, PMHNP
	3444 Wisconsin Ave, Vicksburg, MS 39180-5331
	(601) 638-0031
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Latasha Jackson Claiborne
Gender	Female
Speciality	Registered Nurse
Location	3444 Wisconsin Ave, Vicksburg, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104104413
Provider Enumeration Date: 08/03/2011
Last Update Date: 03/17/2023

Medicare PECOS Information:

PECOS PAC ID: 7214317296
Enrollment ID: I20220707004064

Medical Identifiers

Medical identifiers for Mrs Latasha Jackson Claiborne such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104104413	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	904842 (Mississippi)	Secondary
163W00000X	Registered Nurse	163W00000X (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Latasha Jackson Claiborne allows following entities to bill medicare on her behalf.

Entity Name	Warren Yazoo Mental Health Service
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023002920 PECOS PAC ID: 2365418167 Enrollment ID: O20040902001140

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Latasha Jackson Claiborne is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Latasha Jackson Claiborne, PMHNP 1701 White St, Mccomb, MS 39648 Ph: (601) 249-4214	Mrs Latasha Jackson Claiborne, PMHNP 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031

Reviews and Comments

Registered Nurse Nurses in Vicksburg, MS

Ezrah Gunn, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1110 Clay St, Vicksburg, MS 39183 Phone: 601-738-5820
Andrew Hendrix, CRNA Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-833-5000 Fax: 601-883-5137
Mrs. Erin Sullivan Bennett, NP-C Registered Nurse Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 North, Vicksburg, MS 39183 Phone: 601-529-9980
Casen Lane Hutchinson, NP-C Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2080 S Frontage Rd Ste 109, Vicksburg, MS 39180 Phone: 601-654-7070 Fax: 601-696-6233
Brandon Blake Teller, FNP-C Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2100 Us-61 N, Vicksburg, MS 39183 Phone: 601-415-6161
Reva Marie Mace Walker, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 2007 Highland Pl, Vicksburg, MS 39180 Phone: 601-218-2796
Bethany Ann Whitworth, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031

Mrs Latasha Jackson Claiborne, PMHNP - Medicare Registered Nurse in Vicksburg, MS