Healthcare Provider Details

I. General information

NPI: 1316290935
Provider Name (Legal Business Name): VERLENCIA R MYERS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 LAKELAND EAST DR STE A
FLOWOOD MS
39232-9028
US

IV. Provider business mailing address

5839 HENDERSON RD
PEARL MS
39208-9373
US

V. Phone/Fax

Practice location:
  • Phone: 601-559-9071
  • Fax:
Mailing address:
  • Phone: 601-559-9071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR876299
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907600
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: