Organization
PROVIDENCE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA L TAPPS NURSE PRACTITIONER (CEO OWNER)
(601) 955-4039
Entity
Organization
Contact information
Practice address
4490 HIGHWAY 80 E STE A, PEARL, MS 39208-4206
(601) 335-8600
(240) 219-3126
Mailing address
206 GRAND OAK BLVD, CLINTON, MS 39056-6040
(601) 955-4039
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
04/22/2025
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