person
Martha Maxine Puckett, FNP
Family Nurse Practitioner in De Kalb, Mississippi
NPI 1104808732

Martha Maxine Puckett is a Family Nurse Practitioner based in Meridian, MS and is specialized in Family. Martha Maxine Puckett practices in De Kalb, MS and has the professional credentials of FNP. The NPI Number for Martha Maxine Puckett is 1104808732 and holds a License No. R518425 (Mississippi).

The current practice location address for Martha Maxine Puckett is 14365 Highway 16 W, De Kalb, MS and can be reached out via phone at 601-743-4626 and via fax at 601-743-2133.

Location: 14365 Highway 16 W, De Kalb, MS, 39301-4116
person
Provider Profile Details
NPI Number
1104808732
Provider Name
Martha Maxine Puckett
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
14365 Highway 16 W, De Kalb, MS, 39301-4116
Phone Number
601-743-4626
Fax Number
601-743-2133
Provider Enumeration Date
11/18/2005
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00111106 05 MS
891001100 05 AL
731-02812 01 BLUE CROSS OF AL
970006574 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
14365 Highway 16 W
City
State
Zip
39328-7974
Phone Number
601-743-4626
Fax Number
601-743-2133
person
Provider Business Mailing Address Details
Address
14365 Highway 16 W
City
State
Zip
39328-7974
Phone Number
601-743-4626
Fax Number
601-743-2133
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R518425 (Mississippi)
Definition
Definition to come...
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