Healthcare Provider Details

I. General information

NPI: 1124522909
Provider Name (Legal Business Name): DODIE D MCGEE MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 S OAK STE 2
RAYMOND MS
39154-4205
US

IV. Provider business mailing address

PO BOX 664
RAYMOND MS
39154-0664
US

V. Phone/Fax

Practice location:
  • Phone: 601-259-4442
  • Fax:
Mailing address:
  • Phone: 601-915-2095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902528
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: