TMK ENTERPRISES NPI 1184251795

NPI Information

  • NPI: 1184251795
  • Provider Name: TMK ENTERPRISES
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Doing Business As: SOUTHERN GRACE PSYCHIATRY
  • CLIA Number: 25D2198387
  • Address: 5699 GETWELL RD BLDG F4
    SOUTHAVEN, MS
    ZIP 38672
  • Phone: (662) 372-3495

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NPI Details

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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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