Healthcare Provider Details

I. General information

NPI: 1275458622
Provider Name (Legal Business Name): MAGGIE LOU NUNLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 HIGHWAY 7 S
OXFORD MS
38655-5392
US

IV. Provider business mailing address

1590 ACCESS RD
OXFORD MS
38655-5208
US

V. Phone/Fax

Practice location:
  • Phone: 662-603-8081
  • Fax:
Mailing address:
  • Phone: 662-603-8081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: