# SOUTHLAND WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southland Wellness PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609586346
- **Authorized official:** LINDSAY PACE RN (OWNER)
- **Authorized official phone:** (901) 281-9387

## Contact information

- **Practice address:** 6810 CRUMPLER BLVD STE 100, OLIVE BRANCH, MS 38654-1934
- **Practice address phone:** (662) 892-8728
- **Mailing address:** 6810 CRUMPLER BLVD STE 100, OLIVE BRANCH, MS 38654-1934
- **Mailing address phone:** (662) 892-8728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WI0500X | Infusion Therapy Registered Nurse | — | NULL | — |
| 163WI0500X | Infusion Therapy Registered Nurse | — | — | — |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/05/2022
- **Last updated:** 12/05/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3836655 | — | TN |