Organization
MAGNOLIA MOBILE MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA NANCE FNP-C (OWNER)
(910) 770-3628
Entity
Organization
Contact information
Practice address
6475 PRINCESS ANN RD, EVERGREEN, NC 28438-9519
(910) 770-3628
Mailing address
6475 PRINCESS ANN RD, EVERGREEN, NC 28438-9519
(910) 770-3628
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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