Providence Health, PLLC
NPI 1134795628ActiveOrganization· Nurse Practitioner· Southaven, MS
Nurse Practitioner in Southaven, Mississippi, registered in NPPES in June 2021. The authorized official on file is Irene Wilson, FNP, Fnp-C.
Overview
| NPI | 1134795628 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 3, 2021 |
| Last updated in NPPES | Jun 3, 2021 |
| Certified by provider | Jun 3, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nurse Practitioner providers in Southaven
- 1326816661
- 1659023828
- 1225379050
- 1104497932
- 1225846991
- 1811161763
- 1619226032
- 1023431517
- 1437978657
- 1124067384
- 1124765656
- 1205528833