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NPI Code Detail

MEDICARE: PROF. MARCENIA ALDRIDGE CNFP

MEDICARE:  PROF. MARCENIA  ALDRIDGE  CNFP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR749464MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508815713
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. MARCENIA ALDRIDGE CNFP
Provider Business Mailing Address
First Line : PO BOX 490
Second Line :
City : MCCOMB
State : MS
Zip : 39649-0490
Country : US
Telephone Number : 601-250-4366
Fax Number : 601-250-4367
Provider Business Practice Location Address
First Line : 802 W RAILROAD AVE
Second Line :
City : SUMMIT
State : MS
Zip : 39666-9489
Country : US
Telephone Number : 601-250-4420
Fax Number : 601-250-4421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 02/17/2026

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Directions to “ PROF. MARCENIA ALDRIDGE CNFP” Practice Location

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