Healthcare Provider Details

I. General information

NPI: 1902544547
Provider Name (Legal Business Name): SAVANNAH SIMPSON BARNES DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2778 HIGHWAY 51 S
SENATOBIA MS
38668-9403
US

IV. Provider business mailing address

2778 HIGHWAY 51 S
SENATOBIA MS
38668-9403
US

V. Phone/Fax

Practice location:
  • Phone: 662-560-5966
  • Fax: 662-560-5969
Mailing address:
  • Phone: 662-560-5966
  • Fax: 662-560-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number905347
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: