Provider Demographics
NPI:1710753876
Name:THURMOND, REMONICA (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:REMONICA
Middle Name:
Last Name:THURMOND
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 SHUMATE RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-1540
Mailing Address - Country:US
Mailing Address - Phone:601-934-4740
Mailing Address - Fax:
Practice Address - Street 1:5031 SHUMATE RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1540
Practice Address - Country:US
Practice Address - Phone:601-934-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS883769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health