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General NPI Number Information
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NPI Number | 1003710971
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Entity Type | Organization
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Legal Business Name | CROWNED WITH PURPOSE MENTAL HEALTH WELLNESS SOLUTIONS
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 612 DELEWARE AVE SUITE 18
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City | MCCOMB
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State | MS
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Zip | 39648
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Country | US
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Telephone | 601-803-1147
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Fax |
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Provider Business Mailing Address
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Address Line | 612 DELEWARE AVE SUITE 18
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City | MCCOMB
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State | MS
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Zip | 39648
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Country | US
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Telephone | 601-803-1147
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KANISHA M MCKNIGHT
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Credential | PMHNP
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Telephone | 601-814-0757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | NULL
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