Healthcare Provider Details

I. General information

NPI: 1598691529
Provider Name (Legal Business Name): LENA FAMILY MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 S FOURTH ST
MORTON MS
39117-3407
US

IV. Provider business mailing address

PO BOX 295
LENA MS
39094-0295
US

V. Phone/Fax

Practice location:
  • Phone: 601-654-3433
  • Fax: 833-764-4997
Mailing address:
  • Phone: 601-654-3433
  • Fax: 833-764-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA ANNETTE JOHNSTON
Title or Position: OWNER
Credential: DNP, FNP-C
Phone: 601-654-3433