Organization
VICTORIA L CARROLL, PMHNP-BC, LLC
Active
Other names
Magnolia Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LAUREN CARROLL PMHNP-BC, MSN, APRN (PSYCHIATRIC MENTAL HEALTH NP, OWNER)
(901) 490-0093
Entity
Organization
Contact information
Practice address
740 AVIGNON DR STE C, RIDGELAND, MS 39157-5160
(601) 937-4552
Mailing address
740 AVIGNON DR STE C, RIDGELAND, MS 39157-5160
(601) 937-4552
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427501857
—
MS
Enumeration date
02/04/2025
Last updated
02/04/2025
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