Healthcare Provider Details

I. General information

NPI: 1295654069
Provider Name (Legal Business Name): PHOENIX RISING HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 S VETERANS BLVD
TUPELO MS
38804-5022
US

IV. Provider business mailing address

803 MAYNARD DR
TUPELO MS
38801-5651
US

V. Phone/Fax

Practice location:
  • Phone: 662-401-2793
  • Fax:
Mailing address:
  • Phone: 662-401-2793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VANESSA NICHELLE SATTERWHITE
Title or Position: MANAGING OWNER
Credential: DNP, FNP-C, PMHNP-BC
Phone: 662-401-2793