Individual
TEREA Y MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(662) 579-3955
Mailing address
4591 AIRWAYS BLVD APT 1, MEMPHIS, TN 38116-7692
(662) 562-2787
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN888089
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
906051
MS
Other
Enumeration date
05/27/2021
Last updated
06/19/2023
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