Provider Demographics
NPI:1760782981
Name:BAYS, KATRINA L (FNP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:BAYS
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 1:1732 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-4615
Mailing Address - Country:US
Mailing Address - Phone:662-227-0187
Mailing Address - Fax:601-825-8130
Practice Address - Street 1:1732 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4615
Practice Address - Country:US
Practice Address - Phone:662-227-0187
Practice Address - Fax:601-825-8130
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR858433363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00134216Medicaid
MS00134216Medicaid