Provider Demographics
NPI:1447237409
Name:POSEY, EULA D (FNP)
Entity Type:Individual
Prefix:
First Name:EULA
Middle Name:D
Last Name:POSEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402
Mailing Address - Country:US
Mailing Address - Phone:601-264-6427
Mailing Address - Fax:601-264-6427
Practice Address - Street 1:2737 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401
Practice Address - Country:US
Practice Address - Phone:601-336-7253
Practice Address - Fax:601-336-7254
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR671681207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02055549Medicaid
MS500001889Medicare ID - Type UnspecifiedMS MEDICAREPROVIDERNUMBER
MS02055549Medicaid