Provider Demographics
NPI:1689454571
Name:ATKINS, DEIRDRE (FNP-C)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 SIMPSON HWY 49
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-5391
Mailing Address - Country:US
Mailing Address - Phone:601-439-1420
Mailing Address - Fax:
Practice Address - Street 1:1806 SIMPSON HWY 49
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-5391
Practice Address - Country:US
Practice Address - Phone:601-439-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily