| Purple Magnolia Healthcare Llc | |
|
1520 29th Ave Ste 3 Gulfport MS 39501-2843 | |
| (601) 419-7665 | |
| Not Available |
| Full Name | Purple Magnolia Healthcare Llc |
|---|---|
| Speciality | Nurse Practitioner - Primary Care |
| Location | 1520 29th Ave Ste 3, Gulfport, Mississippi |
| Authorized Official Name and Position | Chancelyn Penn (OWNER AND PRACTITIONER) |
| Authorized Official Contact | 6014197665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purple Magnolia Healthcare Llc 1520 29th Ave Ste 3 Gulfport MS 39501-2843 Ph: (601) 419-7665 | Purple Magnolia Healthcare Llc 1520 29th Ave Ste 3 Gulfport MS 39501-2843 Ph: (601) 419-7665 |
| NPI Number | 1932965563 |
|---|---|
| Provider Enumeration Date | 02/21/2024 |
| Last Update Date | 06/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932965563 | NPI | - | NPPES |
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