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NPI Code Detail

MEDICARE: MRS. CHELSI DESHUN ARCHIE NP

MEDICARE: MRS. CHELSI DESHUN ARCHIE NP
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
1363LF0000XFamily Nurse Practitioner1218590TX
2363LF0000XFamily Nurse Practitioner904960MS

General Provider Information

NPI Number : 1952008963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHELSI DESHUN ARCHIE NP
Provider Business Mailing Address
First Line : 5 FREEDOM CV
Second Line :
City : BYRAM
State : MS
Zip : 39272-8927
Country : US
Telephone Number : 601-750-4720
Fax Number :
Provider Business Practice Location Address
First Line : 1030 RIVER OAKS DR
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-9553
Country : US
Telephone Number : 601-932-1030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2023
Last Update Date : 12/11/2025

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