Manivanh A Prudhomme
MSN, FNP-BC, AGACNP- | Nurse Practitioner - Family | 5+ years Exp
2011 Highway 61 N, Vicksburg
Mississippi, 39183-3918
014-562-2776
Manivanh A Prudhomme is a Vicksburg, Mississippi based nurse practitioner with 5 years of experience in Family. She completed her graduation in 2020. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Manivanh A Prudhomme is 904068 for Family in Mississippi. Her current practice location is 2011 Highway 61 N, Vicksburg. Patients can reach her at 014-562-2776 or can fax her at 601-456-2622. Manivanh A Prudhomme is MSN, FNP-BC, AGACNP- with specialization in Family and her NPI number (Unique professional ID assigned by NPPES) is 1144831140.
Manivanh A Prudhomme delivers family-focused care which means she provides care for patients ranging from infants to the elderly and every age in between. Family Nurse Practitioner (FNP) are frequently the primary care provider for families, which means that they will not only diagnose conditions, but also treat them. FNPs perform physical exams, order diagnostic tests and procedures, diagnose and treat illness, prescribe needed medications, and teach their patients how to develop healthy lifestyles to promote health and prevent disease.
Complete Profile:
Manivanh A Prudhomme speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Manivanh A Prudhomme |
| Specialization: | Family Nurse Practitioner (FNP) |
| Gender: | Female |
| Credentials: | MSN, FNP-BC, AGACNP- |
| Experience: | 5+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2020 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 2011 Highway 61 N, Vicksburg,
Mississippi, 39183-3918 |
| Phone: | 014-562-2776 |
| Fax: | 601-456-2622 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 0648690842 |
| Enrollment ID: | I20201008002132 |
| NPI Number: | 1144831140 |
| NPI Enumeration Date: | 12 Aug, 2020 |
| NPI Last Update On: | 13 Jul, 2021 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Manivanh A Prudhomme are as mentioned below.
| License Number | Specialization | State | Status | |
| 904068 | Family | Mississippi | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Manivanh A Prudhomme
2011 Highway 61 N,
Vicksburg, Mississippi |
| Zip: | 39183 |
| Phone Number: | 601-456-2277 |
| Fax Number: | 601-456-2622 |
Patients can reach Manivanh A Prudhomme at
2011 Highway 61 N, Vicksburg, Mississippi or can
call to book an appointment on 014-562-2776.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.