| Mrs Theresa Danyell Mckissick, APRN | |
| 
					365 Wire Rd W, Perkinston, MS 39573-5723  | |
| (601) 528-1496 | |
| Not Available | 
| Full Name | Mrs Theresa Danyell Mckissick | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 365 Wire Rd W, Perkinston, Mississippi | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1962100347 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 905796 (Mississippi) | Primary | 
| Entity Name | Relias Emergency Medicine Specialists Of Hattiesburg Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1609409440 PECOS PAC ID: 9032549142 Enrollment ID: O20200413002970  | 
| Entity Name | Relias Clinical Decision Specialists Of Hattiesburg Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1336867415 PECOS PAC ID: 3173998358 Enrollment ID: O20230403000431  | 
| Entity Name | Rh Hospitalist Medicine Of Marion General Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1801660170 PECOS PAC ID: 2567815384 Enrollment ID: O20240129002254  | 
| Entity Name | Rh Emergency Medicine Of Highland Community Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033987946 PECOS PAC ID: 4587017918 Enrollment ID: O20240201000844  | 
| Entity Name | Rh Hospitalist Medicine Of Highland Community Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1841068756 PECOS PAC ID: 8022451038 Enrollment ID: O20240207000363  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Theresa Danyell Mckissick, APRN 365 Wire Rd W, Perkinston, MS 39573-5723 Ph: (601) 528-1496  | Mrs Theresa Danyell Mckissick, APRN 365 Wire Rd W, Perkinston, MS 39573-5723 Ph: (601) 528-1496  |