Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Off Main Street Medical PLLC

Organization Family Nurse Practitioner · NPI 1023408614

Off Main Street Medical PLLC is a Family Nurse Practitioner in Taylorsville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2015.

Licensed in
MS
In the registry since
2015
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

336 Eureka St
Taylorsville, MS 39168-0291
Phone: (601) 785-4322
Fax: (601) 785-6681
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R764114 (MS)

Record details

NPI number1023408614
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sharon Scruggs — Owner · (601) 785-4322
NPI enumeratedFebruary 3, 2015
Last updated in NPPESJuly 29, 2021
Certification dateJuly 29, 2021
Mailing addressPo Box 291, 336 Eureka Street, Taylorsville, MS 39168-0291

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