Healthcare Provider Details

I. General information

NPI: 1033016571
Provider Name (Legal Business Name): STEPHANIE BRITT DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2026
Last Update Date: 10/20/2026
Certification Date: 10/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 GETWELL RD STE 1
CORINTH MS
38834-6762
US

IV. Provider business mailing address

902 WESTWOOD CIR
IUKA MS
38852-1201
US

V. Phone/Fax

Practice location:
  • Phone: 662-287-7138
  • Fax:
Mailing address:
  • Phone: 662-660-0516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908818
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: