Organization
PREVENTIVE CARE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYDIA MARIE FRANKLIN FNP (NURSE PRACTITIONER)
(662) 357-7602
Entity
Organization
Contact information
Practice address
2073 OLD HIGHWAY 61 N, STE#2, TUNICA, MS 38676
(662) 357-7602
(662) 357-7621
Mailing address
PO BOX 458, TUNICA, MS 38676-0458
(662) 357-7602
(662) 357-7621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015951
—
MS
Enumeration date
03/31/2006
Last updated
02/25/2011
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