| Nora Cecelia Gough-davis, FNP | |
|
112 W Peeler Ave, Shaw, MS 38773-8710 | |
| (662) 754-3301 | |
| (662) 754-3304 |
| Full Name | Nora Cecelia Gough-davis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 17 Years |
| Location | 112 W Peeler Ave, Shaw, 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 |
|---|---|---|---|
| 1740410661 | NPI | - | NPPES |
| 09801514 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R872155 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bolivar Medical Center | Cleveland, MS | Hospital |
| Entity Name | Shaw Family Medical, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750642633 PECOS PAC ID: 3072769843 Enrollment ID: O20120809000742 |
| Entity Name | Boa Vida Hospital Of Aberdeen Ms Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710405741 PECOS PAC ID: 0244505840 Enrollment ID: O20171128003460 |
| Entity Name | Delta Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215501788 PECOS PAC ID: 5890101208 Enrollment ID: O20210603000314 |
| Entity Name | Making Moves In The Community Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851884266 PECOS PAC ID: 4284038738 Enrollment ID: O20210806000017 |
| Mailing Address | Practice Location Address |
|---|---|
| Nora Cecelia Gough-davis, FNP 112 W Peeler Ave, P.o. Box 299, Shaw, MS 38773-8710 Ph: (662) 754-3301 | Nora Cecelia Gough-davis, FNP 112 W Peeler Ave, Shaw, MS 38773-8710 Ph: (662) 754-3301 |
Teresa Wilson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 | |
Kimberly Robinson, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 Fax: 662-754-3301 | |
Mrs. Willie Mary Bolden, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-745-6638 | |
Tiffany Sherell Newell, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 | |
Mrs. Sereka V Walker, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 Fax: 662-754-3304 | |
Mrs. Regina Jonelle Evans, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 112 W Peeler Ave, Shaw, MS 38773 Phone: 662-754-3301 Fax: 662-754-3304 |