Provider Demographics
NPI:1316278328
Name:DELTA HOUSE CALLS
Entity type:Organization
Organization Name:DELTA HOUSE CALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-357-7602
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:TUNICA
Mailing Address - State:MS
Mailing Address - Zip Code:38676-0458
Mailing Address - Country:US
Mailing Address - Phone:662-357-7602
Mailing Address - Fax:662-357-7621
Practice Address - Street 1:2073 OLD HWY 61 NORTH
Practice Address - Street 2:SUITE # 2
Practice Address - City:TUNICA
Practice Address - State:MS
Practice Address - Zip Code:38676
Practice Address - Country:US
Practice Address - Phone:662-357-7602
Practice Address - Fax:662-357-7621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty