Provider Demographics
NPI:1578243572
Name:MCDONALD, PAULA (FNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 COUNTY ROAD 52832
Mailing Address - Street 2:
Mailing Address - City:HEIDELBERG
Mailing Address - State:MS
Mailing Address - Zip Code:39439-3539
Mailing Address - Country:US
Mailing Address - Phone:601-342-1310
Mailing Address - Fax:
Practice Address - Street 1:714 N PINE AVE
Practice Address - Street 2:
Practice Address - City:HEIDELBERG
Practice Address - State:MS
Practice Address - Zip Code:39439-3290
Practice Address - Country:US
Practice Address - Phone:601-787-2601
Practice Address - Fax:601-787-4283
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905702363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool