Berthold, Anne P
Berthold, Anne P is an individual health care provider with primary practice located at 1227 N State St Ste 101, Jackson MS 39202-2002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Berthold, Anne P can be contacted via phone (601) 355-2485.Contact Information
Primary practice address
1227 N State St Ste 101
Jackson MS 39202-2002
Phone: (601) 355-2485
Fax: (601) 353-1463
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R845073 | Mississippi |
Profile Details
| NPI number | 1821092479 |
|---|---|
| LBN Legal business name | Berthold, Anne P |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Dec 2nd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821092479 | NPPES |
| Mississippi | MEDICAID | 00121962 | |
| Mississippi | MEDICAID | 1432652 |
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