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General NPI Number Information
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NPI Number | 1740495373
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Entity Type | Organization
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Legal Business Name | POPLARVILLE SPECIAL SEPARATE MUNICIPAL SCHOOL DISTRICT
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 804 S JULIA ST
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City | POPLARVILLE
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State | MS
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Zip | 39470-3017
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Country | US
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Telephone | 601-795-8477
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Fax | 601-795-0712
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Provider Business Mailing Address
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Address Line | 804 S JULIA ST
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City | POPLARVILLE
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State | MS
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Zip | 39470-3017
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Country | US
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Telephone | 601-795-8477
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Fax | 601-795-0712
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Authorized Official
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Title or Position | SUPPORT STAFF SPECIALIST
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Name | MRS. LOUISE SMITH
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Credential |
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Telephone | 601-795-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | R859077
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License Number State | MS
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