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

Riverbend Healthcare PLLC

Organization Clinic/Center · NPI 1417620071

Riverbend Healthcare PLLC is a Clinic/Center in Vicksburg, Mississippi. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
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

2011 Hwy 61 N
Vicksburg, MS 39183
Phone: (601) 456-2277
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1417620071
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Manivanh Prudhomme — Ceo · (601) 456-2277
NPI enumeratedJuly 29, 2021
Last updated in NPPESJanuary 17, 2023
Certification dateJanuary 17, 2023
Mailing addressPo Box 29841, Belfast, ME 04915-2050

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