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General NPI Number Information
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NPI Number | 1346057585
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Entity Type | Organization
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Legal Business Name | PANORAMIC CARE
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 5000 HIGHWAY 39 N
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City | MERIDIAN
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State | MS
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Zip | 39301-1021
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Country | US
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Telephone | 601-480-3986
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Fax |
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Provider Business Mailing Address
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Address Line | 6135 B W JOHNSON RD
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City | MERIDIAN
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State | MS
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Zip | 39301-8435
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Country | US
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Telephone | 601-480-3986
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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 | TIFFANY ROULIER
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Credential | NP
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Telephone | 601-480-3986
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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 |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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