Healthcare Provider Details

I. General information

NPI: 1801703145
Provider Name (Legal Business Name): MARY ALEXANDRA SPRINGER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 E MADISON ST
HOUSTON MS
38851-2415
US

IV. Provider business mailing address

902 E MADISON ST
HOUSTON MS
38851-2415
US

V. Phone/Fax

Practice location:
  • Phone: 662-567-5084
  • Fax: 662-567-5168
Mailing address:
  • Phone: 662-567-5084
  • Fax: 662-567-5168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908732
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number918150
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: