institution
East Main Family Medical Clinic Llc
Nurse Practitioner in Tupelo, Mississippi
NPI 1003300815

East Main Family Medical Clinic Llc is a Nurse Practitioner based in Tupelo, MS. East Main Family Medical Clinic Llc practices in Tupelo, MS. The NPI Number for East Main Family Medical Clinic Llc is 1003300815 and holds a License No. R853214 (Mississippi).

The current practice location address for East Main Family Medical Clinic Llc is 1424 E Main St, Tupelo, MS and can be reached out via phone at 662-350-3550 and via fax at 662-842-3061. You can also correspond with East Main Family Medical Clinic Llc through the mailing address at 5024 RAYMOND AVE, TUPELO, MS - 38801-8671 (mailing address contact number: 662-432-0782).

Location: 1424 E Main St, Tupelo, MS, 38801-8671
institution
Provider Profile Details
NPI Number
1003300815
Provider Name
East Main Family Medical Clinic Llc
Credential
Provider Entity Type
Organization
Address
1424 E Main St, Tupelo, MS, 38801-8671
Phone Number
662-350-3550
Fax Number
662-842-3061
Provider Enumeration Date
06/15/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1003300815 05 MS
1003300815 01 MS COMMERCIAL, BCBS
institution
Provider Business Practice Location Address Details
Address
1424 E Main St
City
State
Zip
38804-2956
Phone Number
662-350-3550
Fax Number
662-842-3061
person
Provider Business Mailing Address Details
Address
1424 E Main St
City
State
Zip
38804-2956
Phone Number
662-350-3550
Fax Number
662-842-3061
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
License No.
R853214 (Mississippi)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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