TMK ENTERPRISES NPI 1184251795

NPI Information

NPI: 1184251795
Provider Name: TMK ENTERPRISES

Doing Business As: SOUTHERN GRACE PSYCHIATRY

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 25D2198387

Address:
5699 GETWELL RD BLDG F4
SOUTHAVEN, MS
ZIP 38672
Phone: (662) 372-3495
Get Directions

TMK ENTERPRISES is a psychiatric/mental health nurse practitioner in Southaven, MS. TMK ENTERPRISES NPI is 1184251795. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern Grace Psychiatry.

The provider's business location address is:

5699 GETWELL RD BLDG F4
SOUTHAVEN, MS
ZIP 38672-311
Phone: (662) 372-3495

The provider's authorized official is Teresa Kendrick .
The authorized official title is General Partner and has the following contact phone number (662) 372-3495.

The CLIA number assigned to this NPI record is 25D2198387 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2020 and was last updated on 7/8/2021.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			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

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