TANISHA MARTIN NPI 1649753161

NPI Information

NPI: 1649753161
Provider Name: TANISHA MARTIN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
8626 AIRWAYS BLVD
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 832-0302
Get Directions

Tanisha Martin is a psychiatric/mental health nurse practitioner in Southaven, MS with 6 years of experience. Tanisha Martin NPI is 1649753161. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8626 AIRWAYS BLVD
SOUTHAVEN, MS
ZIP 38671-603
Phone: (662) 832-0302

The NPI 1649753161 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/11/2018 and was last updated on 9/11/2018.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	902907	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: 4/28/2024

NPI Synchronization or Removal

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