Ortho Express Holding Company, LLC
Nurse Practitioner in Booneville, MS. Organization (NPI-2).
NPI number1962029249
StatusActive
Last updated in NPPESSep 10, 2025
Details
- NPI
- 1962029249
- Entity type
- Organization (NPI-2)
- Legal business name
- Ortho Express Holding Company, LLC
- Organization subpart
- No
- Enumeration date
- Jul 2, 2020
- Certification date
- Sep 10, 2025
- Last updated
- Sep 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 261QM2500X | Clinic/Center, Medical Specialty | – | – |
Other names
- Orthoxpress Bone & Joint Center Of Booneville (Doing Business As)
Practice location
608 W Church StBooneville, MS 38829
Phone 662-534-2227 · Fax 662-534-2330
Mailing address
206 Oxford RdNew Albany, MS 38652-3115
Phone 662-534-2227 · Fax 662-534-2330
Authorized official
Jennifer C Bullock
President
6625342227
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