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General NPI Number Information
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NPI Number | 1639973936
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Entity Type | Organization
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Legal Business Name | BATESVILLE PEDIATRIC PLUS
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 590 HIGHWAY 6 E
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City | BATESVILLE
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State | MS
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Zip | 38606-3002
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Country | US
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Telephone | 662-934-6516
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Fax |
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Provider Business Mailing Address
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Address Line | 4837 HIGHWAY 51 S
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City | POPE
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State | MS
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Zip | 38658-7245
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Country | US
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Telephone | 662-267-6480
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Fax |
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Authorized Official
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Title or Position | OWNER/ FNP
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Name | BRITTANY H WILLIS
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Credential | FNP-C
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Telephone | 662-267-6480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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