Provider Demographics
NPI:1972203404
Name:MACIAS, MAGGIE ALEIXANDREA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:ALEIXANDREA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 LEVEE RD
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-7002
Mailing Address - Country:US
Mailing Address - Phone:662-415-9425
Mailing Address - Fax:
Practice Address - Street 1:1506 LEVEE RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-7002
Practice Address - Country:US
Practice Address - Phone:662-415-9425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905867363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily