Healthcare Provider Details

I. General information

NPI: 1154355428
Provider Name (Legal Business Name): MICHELLE S ATKINSON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE S SMITH DNP

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 N PEARL ST
CARTHAGE MS
39051-8220
US

IV. Provider business mailing address

1930 N PEARL ST
CARTHAGE MS
39051-8220
US

V. Phone/Fax

Practice location:
  • Phone: 601-267-8368
  • Fax: 601-267-6639
Mailing address:
  • Phone: 601-267-8368
  • Fax: 601-267-6639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR853540
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: