MEDICARE: PRIMARY SOLUTIONS FAMILY HEALTH CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R866077	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1003984592	OTHER	MS	NPI-INDIVIDUAL

General Provider Information

NPI Number	:	1528210986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY SOLUTIONS FAMILY HEALTH CLINIC INC

Provider Business Mailing Address
First Line	:	1008 CALHOUN AVE
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-2938
Country	:	US
Telephone Number	:	662-751-8847
Fax Number	:	662-751-8848

Provider Business Practice Location Address
First Line	:	1008 CALHOUN AVE
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-2938
Country	:	US
Telephone Number	:	662-751-8847
Fax Number	:	662-751-8848

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	KRISTY L ROBINSON
Credential	:	NP
Telephone Number	:	662-751-8847

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	07/01/2025

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