Healthcare Provider Details

I. General information

NPI: 1669783072
Provider Name (Legal Business Name): PARENT & PARENTING NURSES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CEDARS OF LEBANON RD
JACKSON MS
39206-3604
US

IV. Provider business mailing address

P. O. BOX 2685
JACKSON MS
39207
UM

V. Phone/Fax

Practice location:
  • Phone: 601-613-7879
  • Fax:
Mailing address:
  • Phone: 601-613-7879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1200036056
License Number StateMS

VIII. Authorized Official

Name: MR. CORNELIUS WALKER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 601-613-7879