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NPI Code Detail

MEDICARE: CATHERINE COLEMAN MORDECAI FNP-C

MEDICARE: CATHERINE COLEMAN MORDECAI FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner907750MS

General Provider Information

NPI Number : 1528947645
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE COLEMAN MORDECAI FNP-C
Provider Business Mailing Address
First Line : 622 MACBETH ST
Second Line :
City : BRANDON
State : MS
Zip : 39047-6683
Country : US
Telephone Number : 662-415-6002
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-984-1963
Fax Number : 601-984-1963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2025
Last Update Date : 12/18/2025

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Directions to “ CATHERINE COLEMAN MORDECAI FNP-C” Practice Location

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