Healthcare Provider Details

I. General information

NPI: 1497820310
Provider Name (Legal Business Name): NURSEMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 NORTHRIDGE RD
BALDWYN MS
38824-1173
US

IV. Provider business mailing address

1031 NORTHRIDGE RD
BALDWYN MS
38824-1173
US

V. Phone/Fax

Practice location:
  • Phone: 662-365-9305
  • Fax: 662-365-9304
Mailing address:
  • Phone: 662-365-9305
  • Fax: 662-365-9304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberR622176
License Number StateMS

VIII. Authorized Official

Name: MR. ANITA J TURNER
Title or Position: OWNER
Credential: FNP
Phone: 662-365-9305