FOOT CARE ETC LLC NPI 1407699309

NPI Information

  • NPI: 1407699309
  • Provider Name: FOOT CARE ETC LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 3931 NEWELL RD
    MERIDIAN, MS
    ZIP 39301
  • Phone: (601) 934-8217

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NPI Details

FOOT CARE ETC LLC is a family nurse practitioner in Meridian, MS. FOOT CARE ETC LLC NPI is 1407699309. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3931 NEWELL RD
MERIDIAN, MS
ZIP 39301-440
Phone: (601) 934-8217

The provider's authorized official is Gloria Jean Jackson .
The authorized official title is Owner and has the following contact phone number (601) 934-8217.

The enumeration date for this NPI number is 6/17/2024 and was last updated on 6/17/2024.

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
1213E00000XPodiatristNo
2363LF0000XNurse PractitionerFamilyYes

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
109573377MEDICAIDMISSISSIPPI
2297196YJ96OTHERMISSISSIPPIMEDICARE NUMBER

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

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