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Mississippi Envision :: Quality Healthcare Services Improving Lives
Primary Care Provider Attestation


Please click on the below link to download the Primary Care Provider attestation form and the corresponding Instructions
Primary Care Provider Attestation Form and Instructions

Please allow time for Xerox to process your form once it is submitted. Processing of forms prior to June 30, 2013 may take 10 or more business days depending on the volume received. After that, forms will be processed within 5 business days of receipt. To check on the status of your attestation, please use the search form below.


Primary Care Provider Attestation Status Inquiry
NPI Number