TINA U. MABRY FNP NPI 1003898859

NPI Information

NPI: 1003898859
Provider Name: TINA U. MABRY, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
24489 HIGHWAY 80
LAKE, MS
ZIP 39092
Phone: (601) 775-3264
Get Directions

Tina U. Mabry, FNP is a family nurse practitioner in Lake, MS with 33 years of experience. Tina U. Mabry, FNP NPI is 1003898859. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24489 HIGHWAY 80
LAKE, MS
ZIP 39092-511
Phone: (601) 775-3264
Fax: (601) 775-3097

The NPI 1003898859 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/17/2005 and was last updated on 11/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	R588199	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500008623	OTHER		RAILROAD MEDICARE
2	500000004	MEDICARE ID-TYPE UNSPECIFIED
3	00013436	MEDICAID	MISSISSIPPI
4	R08597	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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