Organization
CONVENIENT CARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE HICKS (CONTROLLER)
(615) 988-2004
Entity
Organization
Contact information
Practice address
3040 GOODMAN RD WEST, HORN LAKE, MS 38637-2474
(662) 578-2030
(615) 301-6550
Mailing address
30 BURTON HILLS BLVD, SUITE 175, NASHVILLE, TN 37215-6403
(615) 864-8713
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015109
—
MS
Enumeration date
09/22/2006
Last updated
08/04/2025
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