Provider Demographics
NPI:1265705289
Name:MAGEE, GYNDLYNN W
Entity type:Individual
Prefix:
First Name:GYNDLYNN
Middle Name:W
Last Name:MAGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:24460 HIGHWAY 430
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-0247
Mailing Address - Country:US
Mailing Address - Phone:985-795-9934
Mailing Address - Fax:985-795-9934
Practice Address - Street 1:24460 HIGHWAY 430
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-2614
Practice Address - Country:US
Practice Address - Phone:985-795-9934
Practice Address - Fax:985-795-9934
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA372600000X372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion