Healthcare Provider Details

I. General information

NPI: 1871312504
Provider Name (Legal Business Name): WOUND CARE PRO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E BANKHEAD ST
NEW ALBANY MS
38652-3910
US

IV. Provider business mailing address

309 E BANKHEAD ST
NEW ALBANY MS
38632
US

V. Phone/Fax

Practice location:
  • Phone: 662-469-5659
  • Fax: 662-929-0007
Mailing address:
  • Phone: 662-469-5659
  • Fax: 662-929-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RYAIN ALEXANDER
Title or Position: OWNER
Credential: AGNP
Phone: 662-587-4153