Provider Demographics
NPI:1518299213
Name:GERALD, KARLA ADAMS (FNP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:ADAMS
Last Name:GERALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:KARLA
Other - Middle Name:MICHELLE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:940 BROOKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-2644
Mailing Address - Country:US
Mailing Address - Phone:601-823-5000
Mailing Address - Fax:601-823-4140
Practice Address - Street 1:940 BROOKWAY BLVD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2644
Practice Address - Country:US
Practice Address - Phone:601-823-5000
Practice Address - Fax:601-823-4140
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR821791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily