Healthcare Provider Details
I. General information
NPI: 1699526947
Provider Name (Legal Business Name): TURNAROUND CARE MEDICAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5357 CLIFF GOOKIN BLVD
TUPELO MS
38801-7085
US
IV. Provider business mailing address
5357 CLIFF GOOKIN BLVD
TUPELO MS
38801-7085
US
V. Phone/Fax
- Phone: 662-523-7016
- Fax:
- Phone: 662-523-7016
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLE
SHERICE
TAYLOR
Title or Position: DOCTOR OF NURSING PRACTICE
Credential: DNP
Phone: 662-523-7016