Individual
MRS. DEANNA MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
2610 S LAMAR BLVD, OXFORD, MS 38655-5243
(622) 234-1731
(662) 236-2392
Mailing address
2610 S LAMAR BLVD, OXFORD, MS 38655-5243
(622) 234-1731
(662) 236-2392
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R658723
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123497
—
MS
Enumeration date
10/06/2005
Last updated
04/03/2017
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