Fryery, Shannon Michelle

Fryery, Shannon Michelle is an individual health care provider with primary practice located at 806 Garfield St , Tupelo MS 38801-5749. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fryery, Shannon Michelle can be contacted via phone (662) 377-5395.

Contact Information

Primary practice address
806 Garfield St Tupelo MS 38801-5749
Phone: (662) 377-5395
Fax: (662) 377-5390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R853471 Mississippi

Profile Details

NPI number 1407895725
LBN Legal business name Fryery, Shannon Michelle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407895725 NPPES
Mississippi MEDICAID 04338295

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