Individual
MAEGAN MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CLPN
Contact information
Practice address
39 SOUTH STREET, CALEDONIA, MS 39740
(662) 356-1560
Mailing address
39 SOUTH STREET, CALEDONIA, MS 39740
(662) 356-1560
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
323859
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323859
LICENSE
MS
Enumeration date
06/13/2025
Last updated
06/13/2025
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