Basic Information
| Provider Information | |||||||||
| NPI: | 1235239179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAGEE | ||||||||
| FirstName: | NITA | ||||||||
| MiddleName: | AURORA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APRN,BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 DAVIS AVE | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390468000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013624471 | ||||||||
| FaxNumber: | 6013683904 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E WOODROW WILSON AVE # 116-A3 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392165116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013624471 | ||||||||
| FaxNumber: | 6013683904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | R850161 | MS | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.