Organization · NPI-2

Magnolia Bloom Women'S Health And Wellness LLC

Nurse Practitioner, Women's Health · Bay Springs, MS

NPI number1831023639
StatusActive
Last updated in NPPESOct 9, 2026

Details

NPI
1831023639
Entity type
Organization (NPI-2)
Legal business name
Magnolia Bloom Women'S Health And Wellness LLC
Organization subpart
No
Enumeration date
Jun 9, 2026
Certification date
Oct 6, 2026
Last updated
Oct 9, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LW0102X Nurse Practitioner, Women's Health––Yes

Practice location

443 Hwy 18
Bay Springs, MS 39422-5187

Phone 601-498-7853

Mailing address

443 Hwy 18
Bay Springs, MS 39422-5187

Phone 601-764-2342 · Fax 601-764-2343

Authorized official

Sarah Russell
Owner/Authorized Official
6017642419

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