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Lacondra Malcom, PMHNP
Psychiatric/Mental Health Nurse Practitioner in Pascagoula, Mississippi
NPI 1487012043

Lacondra Malcom is a Psychiatric/Mental Health Nurse Practitioner based in Pascagoula, MS and is specialized in Psychiatric/Mental Health. Lacondra Malcom practices in Pascagoula, MS and has the professional credentials of PMHNP. The NPI Number for Lacondra Malcom is 1487012043 and holds a License No. R869844 (Mississippi).

The current practice location address for Lacondra Malcom is 4502 Vega St, Pascagoula, MS and can be reached out via phone at 228-696-9224.

Location: 4502 Vega St, Pascagoula, MS, 39581-5305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487012043
Provider Name
Lacondra Malcom
Credential
PMHNP
Provider Entity Type
Individual
Gender
Female
Address
4502 Vega St, Pascagoula, MS, 39581-5305
Phone Number
228-696-9224
Fax Number
Provider Enumeration Date
02/10/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
04307541 05 MS
institution
Provider Business Practice Location Address Details
Address
4502 Vega St
City
Pascagoula
State
Mississippi
Zip
39581-5305
Phone Number
228-696-9224
Fax Number
person
Provider Business Mailing Address Details
Address
4502 Vega St
City
Pascagoula
State
Mississippi
Zip
39581-5305
Phone Number
228-696-9224
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
R869844 (Mississippi)
Definition
Definition to come...
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