Provider Demographics
NPI:1427050418
Name:DENNEY, JAMES L (FNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:DENNEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MEDICAL PLAZA BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-9197
Mailing Address - Country:US
Mailing Address - Phone:601-798-5281
Mailing Address - Fax:601-799-5778
Practice Address - Street 1:12 MEDICAL PLAZA BLVD
Practice Address - Street 2:STE B
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-9197
Practice Address - Country:US
Practice Address - Phone:601-798-5281
Practice Address - Fax:601-799-5778
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR558206363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00122972Medicaid
500000506Medicare PIN
S81995Medicare UPIN