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

Jodi Waller, FNP-C

Individual provider Family Nurse Practitioner · NPI 1811303670

Jodi Waller, FNP-C is a Nurse Practitioner in McComb, Mississippi. Qualified in 2014, 12 years ago. Practices with Statcare PLLC, a 9-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
12
Licensed in
MS
In the registry since
2014
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

300 Rawls Dr Ste 1500
McComb, MS 39648-2878
Phone: (855) 615-7246
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R883312 (MS)

Record details

NPI number1811303670
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJuly 1, 2014
Last updated in NPPESJuly 1, 2014
Mailing address1055 Anglin Rd, Summit, MS 39666-7018

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Statcare Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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