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General NPI Number Information
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NPI Number | 1154106508
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Entity Type | Individual
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Provider Name | LEKISHA CAPRICE PRIDE
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 456 HIGHWAY 6 E
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City | BATESVILLE
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State | MS
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Zip | 38606-3000
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Country | US
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Telephone | 662-547-8159
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Fax | 662-214-6098
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Provider Business Mailing Address
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Address Line | 1221 HARMON RD
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City | BATESVILLE
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State | MS
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Zip | 38606-8630
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Country | US
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Telephone | 662-614-7606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34596
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0024190179
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 34596
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 906205
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 906205
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License Number State | MS
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