EMMANUEL HEALTH SERVICES NPI 1407114432

NPI Information

NPI: 1407114432
Provider Name: EMMANUEL HEALTH SERVICES

Doing Business As: EMMANUEL MEDICAL CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 25D2041299

Address:
637 HIGHWAY 51 NORTH
SUITE E
RIDGELAND, MS
ZIP 39157
Phone: (601) 209-5133
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EMMANUEL HEALTH SERVICES is a family nurse practitioner in Ridgeland, MS. EMMANUEL HEALTH SERVICES NPI is 1407114432. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Emmanuel Medical Clinic.

The provider's business location address is:

637 HIGHWAY 51 NORTH
SUITE E
RIDGELAND, MS
ZIP 39157
Phone: (601) 209-5133

The provider's authorized official is Donna Kay Pittman .
The authorized official title is Ceo and has the following contact phone number (601) 209-5133.

The CLIA number assigned to this NPI record is 25D2041299 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/27/2012 and was last updated on 7/9/2019.

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	R845316	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: 11/14/2023

NPI Synchronization or Removal

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