Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Collietta C Bassett

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063976983

Collietta C Bassett is a Nurse Practitioner in Hernando, Mississippi. Qualified in 2019, 7 years ago. Practices with Ultra Health LLC, a 162-clinician group and accepts Medicare assignment. Licensed in Mississippi, Tennessee and West Virginia.

Years since qualifying
7
Licensed in
MS, TN, WV
In the registry since
2019
Specialties on file
3

Practice location Address checks out

2555 Caffey St
Hernando, MS 38632-2116
Phone: (901) 351-0962
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 903239 (MS)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 25447 (TN)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 110891 (WV)

Record details

NPI number1063976983
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 24, 2019
Last updated in NPPESAugust 5, 2024
Certification dateAugust 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ultra Health Llc — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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