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General NPI Number Information
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NPI Number | 1790648368
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Entity Type | Organization
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Legal Business Name | MIND-BODY CONNECTION, LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 648 MCDAVID AVE SUITE A
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City | LAMBERT
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State | MS
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Zip | 38643
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Country | US
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Telephone | 662-351-4225
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | LAMBERT
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State | MS
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Zip | 38643-0081
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Country | US
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Telephone | 662-351-4225
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | KARMESHA DUKE
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Credential |
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Telephone | 662-351-4225
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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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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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