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Providence Wellness, LLC

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Company Details

Name: Providence Wellness, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 01 Jan 2025 (8 months ago)
Business ID: 1464764
State of Incorporation: MISSISSIPPI

Agent

Name Role Address
Babara L Tapps Agent 206 Grand Oak Blvd, Clinton, MS 39056

Organizer

Name Role Address
Barbara L Tapps Organizer 206 Grand Oak Blvd, Clinton, MS 39056

National Provider Identifier

NPI Number:
1548076490
Certification Date:
2025-04-22

Authorized Person:

Name:
BARBARA L TAPPS
Role:
CEO OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
2402193126

Filings

Type Status Filed Date Description
Formation Form Filed 2024-11-08 Formation For Providence Wellness, LLC

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Date of last update: 23 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website