IndividualActive
Adrienne Tadlock, CPNP-AC
NPI 1033870605 · Pediatric Nurse Practitioner · Jackson, MS
Provider details
- NPI number
- 1033870605
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-AC
- Sex
- Female
- Sole proprietor
- No
- License
- 905076 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-1000
Approximate (ZIP-level) locationGet directions
Mailing address
6026 Chapel Hill Rd
Decatur, MS 39327-9263
Registry dates
- Enumerated
- 2022-01-06
- Last updated
- 2022-01-13
- Certified
- 2022-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.