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Danna Shaye Jackson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

6524 U S Highway 98, Hattiesburg, MS 39402-8569

PECOS Enrollment

This provider is enrolled in PECOS as DANNA JACKSON.

Based on the most recent information from CMS, provider Danna Shaye Jackson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1093322885
Provider Type
Individual
Full Name
Jackson, Danna Shaye
Title
Mrs.
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
9/25/2020
Last Updated
5/19/2022

Contact Information

Practice Location

6524 U S Highway 98, Hattiesburg, MS 39402-8569

(601) 268-9393

Unlisted Fax

Mailing Location

115 Howard Heights Rd, Poplarville, MS 39470-7454

(601) 447-8778

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 905263 Mississippi
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Danna Shaye Jackson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Mooney, Kelli P.

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Chatham, Tarah

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Brumfield, Shermanda M

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Hutton Healthcare Services

Hudson, Thomas Neil