Individual
MRS. MAGGIE MARTIN FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
101 WILBURN WAY, STARKVILLE, MS 39759-3693
(662) 323-9908
(662) 323-8948
Mailing address
101 WILBURN WAY, STARKVILLE, MS 39759-3693
(662) 323-9908
(662) 323-8948
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R860376
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02906593
—
MS
Enumeration date
05/11/2006
Last updated
06/06/2011
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