Provider Demographics
NPI:1053191338
Name:LOGGINS, SALINA M (NP-BC)
Entity type:Individual
Prefix:
First Name:SALINA
Middle Name:M
Last Name:LOGGINS
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-4920
Mailing Address - Country:US
Mailing Address - Phone:601-260-3378
Mailing Address - Fax:
Practice Address - Street 1:215 KATHERINE DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9588
Practice Address - Country:US
Practice Address - Phone:601-665-4162
Practice Address - Fax:888-398-1151
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily