Individual
PHAEDRA MCLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
823 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-0100
(601) 794-0247
Mailing address
823 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-0100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R856419
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R856419
MS
Other
Enumeration date
09/17/2014
Last updated
04/17/2023
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