Organization · Type 2 NPI

Emmanuel Health Services

Family Nurse Practitioner · Ridgeland, MS

NPI number 1407114432 Active

Practice location

637 Highway 51 North, Suite E
Ridgeland, MS 39157

Call (601) 209-5133 Map

Mailing address

PO Box 2056
Ridgeland, MS 39158-2056

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	R845316 (MS)

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NPI record

NPI: 1407114432
Entity type: Organization (Type 2)
Issued: Apr 27, 2012
Last updated: Jul 9, 2019
Status: Active

Other names

<unavail>
Emmanuel Medical Clinic · doing business as
Emmanuel Medical Clinic · doing business as

Authorized official

Ms. Donna Kay Pittman, FNP
CEO
(601) 209-5133

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407114432

Emmanuel Health Services's National Provider Identifier is 1407114432, issued on Apr 27, 2012. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Ridgeland, MS. The record was last updated on Jul 9, 2019.