360 Healthcare Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

360 HEALTHCARE CLINIC

Practice address

202 Saint Paul St
Pearl, MS 39208-5134

Phone

(769) 572-7819

NPI assigned

Jul 16, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Denetta D Parker, NP-C

Title

Owner

Phone

(769) 572-7819

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1952919953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SAINT PAUL ST",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085134",
            "telephone_number": "769-572-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SAINT PAUL ST",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392085134",
            "telephone_number": "769-572-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 HEALTHCARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "DENETTA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "769-572-7819",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Pearl, MS
• Providers in Pearl, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.