Individual
LOGAN SCOTT LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-3000
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
915724
MS
363L00000X
Nurse Practitioner
907813
MS
Other
Enumeration date
06/14/2024
Last updated
09/30/2025
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