MEDICARE: VITAL TOUCH DIRECT CARE, PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1497697874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL TOUCH DIRECT CARE, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 107
Second Line	:
City	:	RAYMOND
State	:	MS
Zip	:	39154-0107
Country	:	US
Telephone Number	:	601-906-9680
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 ELIZABETH CHAPMAN DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39212-3252
Country	:	US
Telephone Number	:	601-906-9680
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FLORA DENISE GRAY HALEY
Credential	:	FNP-C
Telephone Number	:	601-906-9680

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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