Healthcare Provider Details

I. General information

NPI: 1700125002
Provider Name (Legal Business Name): VALERIE ORCUTT ANTICI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE ORCUTT ANTICI FNP-C

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 MAIN ST
ROSEDALE MS
38769
US

IV. Provider business mailing address

702 MARTIN LUTHER KING ST
MOUND BAYOU MS
38762-9314
US

V. Phone/Fax

Practice location:
  • Phone: 662-873-6933
  • Fax: 662-873-6986
Mailing address:
  • Phone: 662-873-6933
  • Fax: 662-873-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR878089
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: