Provider Demographics
NPI:1386866358
Name:MAGEE, LAUREN E (RD,LD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:MAGEE
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MORGANTI-ADMIN. FINANCE
Mailing Address - Street 2:PO BOX 23090
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-3090
Mailing Address - Country:US
Mailing Address - Phone:601-968-1362
Mailing Address - Fax:601-292-4592
Practice Address - Street 1:1225 NORTH STATE STREET
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202
Practice Address - Country:US
Practice Address - Phone:601-968-1362
Practice Address - Fax:601-292-4592
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1068133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered