Healthcare Provider Details

I. General information

NPI: 1871907816
Provider Name (Legal Business Name): UNEEDUS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 OLD BROOKHAVEN RD
SUMMIT MS
39666-8168
US

IV. Provider business mailing address

3013 OLD BROOKHAVEN RD
SUMMIT MS
39666-8168
US

V. Phone/Fax

Practice location:
  • Phone: 601-810-5039
  • Fax: 601-944-9780
Mailing address:
  • Phone: 601-810-5039
  • Fax: 601-944-9780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHELBY WHITE
Title or Position: OWNER
Credential: CFNP
Phone: 601-810-5039