MEDICARE: SETTLEMIRES FAMILY MEDICAL CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1265072821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SETTLEMIRES FAMILY MEDICAL CLINIC, LLC

Provider Business Mailing Address
First Line	:	3198 HIGHWAY 72 W
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-9303
Country	:	US
Telephone Number	:	662-594-8184
Fax Number	:	662-594-8242

Provider Business Practice Location Address
First Line	:	3198 HIGHWAY 72 W
Second Line	:
City	:	CORINTH
State	:	MS
Zip	:	38834-9303
Country	:	US
Telephone Number	:	662-594-8184
Fax Number	:	662-594-8242

Authorized Official
Title or Position	:	OWNER
Name	:	SHEILA GALYEAN SETTLEMIRES
Credential	:	FNP-BC
Telephone Number	:	625-964-8184

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	02/04/2020

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