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NPI Code Detail

MEDICARE: ASHLAN VANBUREN

MEDICARE: ASHLAN VANBUREN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1902748890
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLAN VANBUREN
Provider Business Mailing Address
First Line : 4780 I 55 N STE 105
Second Line :
City : JACKSON
State : MS
Zip : 39211-5542
Country : US
Telephone Number : 601-956-4816
Fax Number : 601-956-4817
Provider Business Practice Location Address
First Line : 4780 I 55 N STE 105
Second Line :
City : JACKSON
State : MS
Zip : 39211-5542
Country : US
Telephone Number : 601-956-4816
Fax Number : 601-956-4817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

Similar Medicare Providers

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1326232935 — MARY HATHORN MS
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1477735769 — TYRA WADE
Practice Location Address:
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1639353592 — KEANDREA JACKSON M.A.
Practice Location Address:
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39211-5542
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1548697121 — SHIRLEY JONES MSW, CMHT
Practice Location Address:
4780 I 55 N STE 105
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Directions to “ ASHLAN VANBUREN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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