Organization
MAGNOLIA MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA DIANNE CLEGG-ALDERMAN FNP-BC (OWNER)
(662) 321-3709
Entity
Organization
Contact information
Practice address
109 CLERMONT CT, TUPELO, MS 38801-0003
(662) 321-3709
Mailing address
109 CLERMONT CT, TUPELO, MS 38801-0003
(662) 321-3709
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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