DIVINITY HEALTHCARE INC NPI 1396567301

NPI Information

  • NPI: 1396567301
  • Provider Name: DIVINITY HEALTHCARE INC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • :
  • CLIA Number: 25D2327159
  • Address: 99 WINCHESTER DR UNIT K
    WEST POINT, MS
    ZIP 39773
  • Phone: (662) 848-3656

Map and Directions

Get Directions

NPI Details

DIVINITY HEALTHCARE INC is a family nurse practitioner in West Point, MS. DIVINITY HEALTHCARE INC NPI is 1396567301. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

99 WINCHESTER DR UNIT K
WEST POINT, MS
ZIP 39773-083
Phone: (662) 848-3656

The provider's authorized official is Trinity Sharda Johnson .
The authorized official title is Owner and has the following contact phone number (662) 848-3656.

The CLIA number assigned to this NPI record is 25D2327159 - other - primary family care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/30/2024 and was last updated on 4/7/2025.

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
1261QP2300XClinic/CenterPrimary CareNo
2363LF0000XNurse PractitionerFamilyYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI