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General NPI Number Information
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NPI Number | 1679387286
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Entity Type | Organization
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Legal Business Name | VICTORIA L CARROLL, PMHNP-BC, LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 740 AVIGNON DR STE C
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City | RIDGELAND
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State | MS
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Zip | 39157-5160
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Country | US
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Telephone | 601-937-4552
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Fax |
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Provider Business Mailing Address
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Address Line | 740 AVIGNON DR STE C
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City | RIDGELAND
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State | MS
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Zip | 39157-5160
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Country | US
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Telephone | 601-937-4552
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NP, OWNER
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Name | VICTORIA LAUREN CARROLL
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Credential | PMHNP-BC, MSN, APRN
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Telephone | 901-490-0093
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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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