Provider Demographics
NPI:1235340910
Name:MAGEE, BESSIE L (NURSE)
Entity Type:Individual
Prefix:MS
First Name:BESSIE
Middle Name:L
Last Name:MAGEE
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-7187
Mailing Address - Country:US
Mailing Address - Phone:601-876-6784
Mailing Address - Fax:601-876-6784
Practice Address - Street 1:190 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-7187
Practice Address - Country:US
Practice Address - Phone:601-876-6784
Practice Address - Fax:601-876-6784
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS00000319376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00000319Medicaid
MS00530861Medicaid