Healthcare Provider Details

I. General information

NPI: 1932850229
Provider Name (Legal Business Name): PROFICIENT HEALTHCARE STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 COUNTY FARM RD
RAYMOND MS
39154-9301
US

IV. Provider business mailing address

409 BALD CYPRESS CV
TERRY MS
39170-6002
US

V. Phone/Fax

Practice location:
  • Phone: 601-863-0258
  • Fax: 601-990-4288
Mailing address:
  • Phone: 601-863-0258
  • Fax: 601-990-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA LAIRD
Title or Position: CEO
Credential: RN
Phone: 601-863-0258