Collaborativenp Health Center LLC
Nurse Practitioner, Family in Osyka, MS. Organization (NPI-2).
NPI number1316728512
StatusActive
Last updated in NPPESJan 3, 2025
Details
- NPI
- 1316728512
- Entity type
- Organization (NPI-2)
- Legal business name
- Collaborativenp Health Center LLC
- Organization subpart
- No
- Enumeration date
- Oct 12, 2023
- Certification date
- Jan 3, 2025
- Last updated
- Jan 3, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
1081 Second StOsyka, MS 39657-8076
Phone 769-264-7004 · Fax 866-493-3926
Mailing address
Po Box 400Osyka, MS 39657-0400
Phone 769-264-7004 · Fax 866-493-3926
Authorized official
Ellen Denise Harris
Owner
8087240177
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