| Quinn Wellness | |
| 128 W Cunningham Ave Terry MS 39170 | |
| (769) 666-9021 | |
| Not Available | 
| Full Name | Quinn Wellness | 
|---|---|
| Speciality | Family Medicine | 
| Location | 128 W Cunningham Ave, Terry, Mississippi | 
| Authorized Official Name and Position | Melissa Quinn (OPERATIONS) | 
| Authorized Official Contact | 7696669021 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Quinn Wellness 768 Avery Blvd N Ridgeland MS 39157-5219 Ph: (601) 487-6482 | Quinn Wellness 128 W Cunningham Ave Terry MS 39170 Ph: (769) 666-9021 | 
| NPI Number | 1396502589 | 
|---|---|
| Provider Enumeration Date | 03/04/2024 | 
| Last Update Date | 03/04/2024 | 
| Medicare PECOS PAC ID | 1153760574 | 
|---|---|
| Medicare Enrollment ID | O20240418001732 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1396502589 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Timothy M Quinn | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1447350483 PECOS PAC ID: 8921074410 Enrollment ID: I20100809000730 | 
| Provider Name | Ebonique Martin Buckner | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1003465352 PECOS PAC ID: 6305240045 Enrollment ID: I20210803002249 | 
| Provider Name | Keianna Renae Luckett | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1992480859 PECOS PAC ID: 1052760881 Enrollment ID: I20231205003871 | 
| Provider Name | Michaela Smith | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1407504772 PECOS PAC ID: 8123461670 Enrollment ID: I20240212002756 | 
| Whitney William Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1290 Caroline Dr, Terry, MS 39170 Phone: 601-944-1717 Fax: 601-944-9780 | |
| Central Mississippi Civic Improvement Association, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2009 Byram Bulldog Blvd, Terry, MS 39170 Phone: 601-362-5321 Fax: 601-364-5159 | |
| Central Mississippi Civic Improvement Association, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 235 W Beasley St, Terry, MS 39170 Phone: 601-362-5321 Fax: 601-364-5159 |