Magnolia Family Clinic | |
82 Main St Rienzi MS 38865-9144 | |
(662) 293-6699 | |
(662) 293-6698 |
Full Name | Magnolia Family Clinic |
---|---|
Speciality | Family Medicine |
Location | 82 Main St, Rienzi, Mississippi |
Authorized Official Name and Position | Deonne Henry (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6622931076 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Magnolia Family Clinic 401 Alcorn Dr Ste 2c Corinth MS 38834-9073 Ph: (662) 293-7618 | Magnolia Family Clinic 82 Main St Rienzi MS 38865-9144 Ph: (662) 293-6699 |
NPI Number | 1508303348 |
---|---|
Provider Enumeration Date | 01/31/2017 |
Last Update Date | 07/15/2022 |
Medicare PECOS PAC ID | 3072899541 |
---|---|
Medicare Enrollment ID | O20170418000447 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508303348 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Erica L Yates |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306869375 PECOS PAC ID: 3779567011 Enrollment ID: I20040615001066 |
Provider Name | Laquita W Bain |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437238938 PECOS PAC ID: 1456305762 Enrollment ID: I20050615000569 |
Provider Name | Brittney Leeann Plunk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639705338 PECOS PAC ID: 3971994682 Enrollment ID: I20220106000558 |
Provider Name | Holley Trimble |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861102196 PECOS PAC ID: 5092180653 Enrollment ID: I20230412002330 |
Provider Name | Jennifer Elaine Pickens |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053884106 PECOS PAC ID: 4486003175 Enrollment ID: I20231206002538 |