Adrienne Kelsey Tadlock
Nurse Practitioner - Pediatrics
2500 N State St
Jackson
, Mississippi 39216-4500
Adrienne Kelsey Tadlock
Nurse Practitioner - Pediatrics
2500 N State St
Jackson
, Mississippi 39216-4500
(601) 692-5036
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Adrienne Kelsey Tadlock
- 6026 Chapel Hill Rd
- Decatur, MS
- Zip : 39327-9263
- Phone : (601) 692-5036
Second Address
- Adrienne Kelsey Tadlock
- 2500 N State St
- Jackson, MS
- Zip : 39216-4500
- Phone : (601) 984-1000
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Is Adrienne Kelsey Tadlock a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 905076 | MS |
National Provider Identifier
| NPI | 1033870605 |
|---|---|
| Provider Name | Adrienne Kelsey Tadlock |
| First Address | Decatur, MS 39327-9263 |
| Second Address | Jackson, MS 39216-4500 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/01/2022 |
| Last Update Date | 13/01/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.