Healthcare Provider Details
I. General information
NPI: 1679109458
Provider Name (Legal Business Name): KARI ANNA ADAMS NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/12/2020
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 N STATE ST
JACKSON MS
39216-4500
US
IV. Provider business mailing address
114 WINCHESTER PL
SALTILLO MS
38866-6807
US
V. Phone/Fax
- Phone: 601-984-2400
- Fax:
- Phone: 601-720-4472
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LN0000X |
| Taxonomy | Neonatal Nurse Practitioner |
| License Number | 903788 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LN0005X |
| Taxonomy | Critical Care Neonatal Nurse Practitioner |
| License Number | 903788 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: