Provider Demographics
NPI:1306118823
Name:ABUNDANT HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ABUNDANT HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAPPS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:601-718-7827
Mailing Address - Street 1:PO BOX 13466
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39236-3466
Mailing Address - Country:US
Mailing Address - Phone:601-718-7827
Mailing Address - Fax:
Practice Address - Street 1:6029 KRISTEN DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2817
Practice Address - Country:US
Practice Address - Phone:601-718-7827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR856470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty