ETERNITY WELLNESS 22 LLC NPI 1639836000

NPI Information

  • NPI: 1639836000
  • Provider Name: ETERNITY WELLNESS 22, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1636 POPPS FERRY RD STE 234
    BILOXI, MS
    ZIP 39532
  • Phone: (888) 777-2671

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NPI Details

ETERNITY WELLNESS 22, LLC is a psychiatric/mental health nurse practitioner in Biloxi, MS. ETERNITY WELLNESS 22, LLC NPI is 1639836000. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1636 POPPS FERRY RD STE 234
BILOXI, MS
ZIP 39532-279
Phone: (888) 777-2671
Fax: (228) 641-2499

The provider's authorized official is Tawana Chanell Raymond .
The authorized official title is Nurse Practitioner, Owner and has the following contact phone number (228) 641-2449.

The enumeration date for this NPI number is 11/19/2021 and was last updated on 4/18/2024.

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
1363LF0000XNurse PractitionerFamilyNo
2363LP0808XNurse 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: 11/21/2025

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