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General NPI Number Information
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NPI Number | 1336430594
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Entity Type | Organization
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Legal Business Name | PRIMARY HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 10404 TUCKER RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39565-7922
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Country | US
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Telephone | 228-354-9505
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Fax | 228-354-9575
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Provider Business Mailing Address
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Address Line | PO BOX 6190
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City | DIBERVILLE
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State | MS
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Zip | 39540-6190
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Country | US
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Telephone | 228-354-9505
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Fax | 228-354-9575
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Authorized Official
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Title or Position | ADULT ACUTE CARE NURSE PRACTITIONER
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Name | MS. NANCY ANN BUCKHEISTER
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Credential | ACNP
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Telephone | 228-354-9505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6705
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 6705
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License Number State | MS
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