A Healthy You Medical Clinic, 'L.L.C.'
Organization Active NPI Nurse Practitioner · Clarksdale, MS
NPI 1982140448 · NPPES record last updated May 20, 2019
Key facts
- NPI
- 1982140448
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- A HEALTHY YOU MEDICAL CLINIC, 'L.L.C.'
- Practice address
- 1202 Desoto Ave
Suite a
Clarksdale, MS 38614-6937 - Phone
- (662) 209-1202
- Fax
- (662) 483-1627
- NPI assigned
- Jan 9, 2017
- Organization subpart
- No
Authorized official
- Name
- Lula Owens Hoskins, APRN
- Title
- Provider
- Phone
- (662) 209-1202
Practitioners 2
-
Lula Owens Hoskins, FNP
-
Teri Williams, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170313002001 | MS | Part B Supplier - Clinic/Group Practice | 3274818265 |
Receives reassigned benefits from 2 practitioners Practice locations: Clarksdale, MS |
National Provider Directory
Locations
1202 Desoto Ave
Ste A
Clarksdale, MS 38614
Phone (662) 209-1202
1202 Highway 49 S
Clarksdale, MS 38614
Phone (662) 202-1297
1202 Desoto Ave
Ste A49
Clarksdale, MS 38614
Interoperability endpoints
- https://api.platform.athenahealth.com/19269/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
1202 Desoto Ave
Suite a
Clarksdale, MS 38614-6937
Mailing address
1202 Desoto Ave
Suite a
Clarksdale, MS 38614-6937
Phone (662) 209-1202
Other providers in Clarksdale, MS
- 3 Brothers Pharmacy LLC
- 340 Desoto Avenue Ext Operations, LLC
- A Clear Mind, PLLC
- Aaron E Henry Community Health
- Aaron E Henry Community Health
- Aaron E Henry Community Health
- Aaron E. Henry Community Health
- Aaron E. Henry Community Health Services Center, Inc
All providers in Clarksdale, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.