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General NPI Number Information
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NPI Number | 1578913885
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Entity Type | Organization
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Legal Business Name | IN FOCUS PSYCHIATRY LLC
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 220 OAK TREE DR
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City | HERNANDO
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State | MS
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Zip | 38632-1196
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Country | US
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Telephone | 662-510-8606
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 770
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City | HERNANDO
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State | MS
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Zip | 38632-0770
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | BEN HARRELL
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Credential |
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Telephone | 662-510-8606
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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 | 901502
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License Number State | MS
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