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General NPI Number Information
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NPI Number | 1699423939
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Entity Type | Individual
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Provider Name | ERICA THURMAN NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 215 KATHERINE DR
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City | FLOWOOD
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State | MS
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Zip | 39232-9588
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Country | US
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Telephone | 601-665-4162
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Fax | 855-830-3484
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Provider Business Mailing Address
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Address Line | 1621 W PEACE ST
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City | CANTON
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State | MS
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Zip | 39046-9041
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Country | US
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Telephone | 601-665-2396
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 905257
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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