CHILDREN'S ACCELERATION PROGRAM INC NPI 1093865933

NPI Information

  • NPI: 1093865933
  • Provider Name: CHILDREN'S ACCELERATION PROGRAM, INC
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Organization
  • Address: 112 ISSAQUENA AVE
    CLARKSDALE, MS
    ZIP 38614
  • Phone: (662) 627-2741

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NPI Details

CHILDREN'S ACCELERATION PROGRAM, INC is a pediatrics nurse practitioner in Clarksdale, MS. CHILDREN'S ACCELERATION PROGRAM, INC NPI is 1093865933. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

112 ISSAQUENA AVE
CLARKSDALE, MS
ZIP 38614-315
Phone: (662) 627-2741

The provider's authorized official is Doris Mitchell .
The authorized official title is Director and has the following contact phone number (662) 627-2741.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 8/22/2020.

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
1363LP0200XNurse PractitionerPediatricsR125740MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100009266MEDICAIDMISSISSIPPI
200020541MEDICAIDMISSISSIPPI

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: 3/30/2025

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