Healthcare Provider Details

I. General information

NPI: 1982002952
Provider Name (Legal Business Name): BELLEVUE ELEMENTARY SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 OLD HIGHWAY 24
HATTIESBURG MS
39402-8235
US

IV. Provider business mailing address

424 MARTIN LUTHER KING DR
PURVIS MS
39475-5028
US

V. Phone/Fax

Practice location:
  • Phone: 601-264-6724
  • Fax:
Mailing address:
  • Phone: 601-974-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR888519
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number876971
License Number StateMS

VIII. Authorized Official

Name: DR. STEVE HAMPTON SR.
Title or Position: SUPERINTENDENT OF EDUCATION
Credential:
Phone: 601-794-1030