Individual
ELIZABETH MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
927 KEMPER STREET, SCOOBA, MS 39358
(662) 476-9595
(601) 553-8175
Mailing address
2701 DAVIS STREET, MERIDIAN, MS 39301-5708
(601) 693-0118
(601) 553-8175
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R559237
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116995
—
MS
Enumeration date
11/01/2006
Last updated
02/10/2017
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