OrganizationActive
Healthy Me
NPI 1508186024 · Acute Care Clinical Nurse Specialist · Coffeeville, MS
Provider details
- NPI number
- 1508186024
- Entity type
- Organization
- Primary specialty
- Acute Care Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Leresha Gerard, Ceo/Administrator(662) 226-4010
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
104 Davis St
Coffeeville, MS 38922-9273
Phone: (662) 614-3031
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 186
Grenada, MS 38902-0186
Registry dates
- Enumerated
- 2010-06-07
- Last updated
- 2010-06-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.