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EVERGREEN CLINI
NPI 1396763298
Nurse Practitioner - Family in Nettleton, MS

Active since July 18, 2006
4929 HIGHWAY 371 S, NETTLETON, MS 38858(662) 963-9154(662) 963-9157 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Clini NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN CLINI (NPI 1396763298) is a healthcare organization registered as a family in Nettleton, Mississippi and active in the NPI registry since July 2006. The organization lists Jerry Stevens, Administration, as its authorized official.

NPPES Registry Identity

NPI1396763298
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameEVERGREEN CLINI
Location Address4929 HIGHWAY 371 SNettleton, MS 38858-6901
Mailing Address4929 Highway 371 SNettleton, MS 38858-6901 · (662) 963-9154 · Fax (662) 963-9157
Phone(662) 963-9154
Fax(662) 963-9157
Organization SubpartNo
Authorized OfficialJerry StevensAdministration · (662) 963-9154
Enumeration DateJuly 18, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1396763298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
4929 HIGHWAY 371 S, Nettleton, MS 38858
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Other Identifiers 1

Medicaid09013494MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVERGREEN FAMILY MEDICAL CLINIC INC
Clinic/Center (Rural Health)
4929 HIGHWAY 371 S
NETTLETON, MS 38858
Lee County (662) 963-9154
FAMILY CARE OF EVERGREEN, LLC
Nurse Practitioner
4929 HIGHWAY 371 S
NETTLETON, MS 38858
Lee County (662) 963-9154

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Clini's NPI number?

The NPI number for Evergreen Clini is 1396763298. It was assigned to this organization in the NPPES registry on July 18, 2006.

Where is Evergreen Clini located?

Evergreen Clini is located at 4929 Highway 371 S, Nettleton, MS 38858. The listed phone number is (662) 963-9154.

What is Evergreen Clini's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Evergreen Clini was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.