Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Adrienne Kelsey Tadlock, CPNP-AC

Individual provider Pediatric Nurse Practitioner · NPI 1033870605

Adrienne Kelsey Tadlock, CPNP-AC is a Nurse Practitioner in Jackson, Mississippi. Graduated from University of Mississippi School of Medicine in 2021, 5 years ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
5
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2022
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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 905076 (MS)

Record details

NPI number1033870605
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP-AC
Sole proprietorNo
NPI enumeratedJanuary 6, 2022
Last updated in NPPESJanuary 13, 2022
Certification dateJanuary 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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