Individual
LAFADRA ANTONETTE MACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
934 S GLOSTER ST, TUPELO, MS 38801-6312
(662) 346-5846
Mailing address
934 S GLOSTER ST, TUPELO, MS 38801-6312
(662) 346-5846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904666
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
904666
MS
Other
Enumeration date
09/30/2021
Last updated
10/01/2025
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