Provider Demographics
NPI:1659023828
Name:PRIORITY HEALTH AND CONSULTANT LLC
Entity Type:Organization
Organization Name:PRIORITY HEALTH AND CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN FNP-C
Authorized Official - Phone:901-517-3059
Mailing Address - Street 1:2355 CHRISTIAN LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-4451
Mailing Address - Country:US
Mailing Address - Phone:901-517-3059
Mailing Address - Fax:
Practice Address - Street 1:2355 CHRISTIAN LN
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4451
Practice Address - Country:US
Practice Address - Phone:901-517-3059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty