Healthcare Provider Details

I. General information

NPI: 1538786090
Provider Name (Legal Business Name): ESSENTIAL HEALTH & WELLNESS CLINIC P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5842 GOODMAN RD STE 1
HORN LAKE MS
38637-8106
US

IV. Provider business mailing address

5842 GOODMAN RD STE 1
HORN LAKE MS
38637-8106
US

V. Phone/Fax

Practice location:
  • Phone: 662-449-6570
  • Fax: 662-510-8586
Mailing address:
  • Phone: 662-449-6570
  • Fax: 662-510-8586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA MURRY
Title or Position: OWNER
Credential:
Phone: 662-347-1953