Organization
RIVERBEND HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANIVANH A PRUDHOMME FNP (CEO)
(601) 456-2277
Entity
Organization
Contact information
Practice address
2011 HWY 61 N, VICKSBURG, MS 39183
(601) 456-2277
Mailing address
PO BOX 29841, BELFAST, ME 04915-2050
(601) 456-2277
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/29/2021
Last updated
01/17/2023
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