1134210693 NPI number — CAROLE-LYNNE SINGLETON CFNP

Table of content: CAROLE-LYNNE SINGLETON CFNP (NPI 1134210693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134210693 NPI number — CAROLE-LYNNE SINGLETON CFNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGLETON
Provider First Name:
CAROLE-LYNNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CFNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134210693
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7048 OLD CANTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIDGELAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39157-1008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-992-9790
Provider Business Mailing Address Fax Number:
601-992-9796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 FOUR LANE HIGHWAY 49
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENTONIA
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39040-9433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-998-8900
Provider Business Practice Location Address Fax Number:
662-528-4017
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R853218 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05638867 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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