Provider Demographics
NPI:1790674182
Name:FOOS, MAGHAN (FNP-C)
Entity type:Individual
Prefix:
First Name:MAGHAN
Middle Name:
Last Name:FOOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 TIMBER RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-2528
Mailing Address - Country:US
Mailing Address - Phone:228-234-2455
Mailing Address - Fax:
Practice Address - Street 1:303 REESE ST
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-2823
Practice Address - Country:US
Practice Address - Phone:228-493-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily