SHADA BREEZE TENNYSON FNP-C NPI 1043851587

NPI Information

NPI: 1043851587
Provider Name: SHADA BREEZE TENNYSON, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1018 N GLOSTER ST
TUPELO, MS
ZIP 38804
Phone: (662) 523-4950
Get Directions

Shada Breeze Tennyson, FNP-C is a family nurse practitioner in Tupelo, MS with 5 years of experience. Shada Breeze Tennyson, FNP-C NPI is 1043851587. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1018 N GLOSTER ST
TUPELO, MS
ZIP 38804-297
Phone: (662) 523-4950
Fax: (662) 890-5746

The NPI 1043851587 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/7/2019 and was last updated on 11/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	903537	MISSISSIPPI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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