Healthcare Provider Details

I. General information

NPI: 1871844498
Provider Name (Legal Business Name): DAWN CAPRICE PEERY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 KATHERINE DR STE A
FLOWOOD MS
39232-9588
US

IV. Provider business mailing address

128 COUNTRY CLUB DR
GREENWOOD MS
38930-6802
US

V. Phone/Fax

Practice location:
  • Phone: 601-665-4162
  • Fax: 888-398-1151
Mailing address:
  • Phone: 662-897-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number860299
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: