Shirley, Gwendolyn Pitcock
Shirley, Gwendolyn Pitcock is an sole proprietor health care provider with primary practice located at 2149 Stateline Rd W , Southaven MS 38671-1222. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Shirley, Gwendolyn Pitcock can be contacted via phone (662) 342-1112.Contact Information
Primary practice address
2149 Stateline Rd W
Southaven MS 38671-1222
Phone: (662) 342-1112
Fax: (662) 342-1116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R858450 | Mississippi |
Profile Details
| NPI number | 1871726182 |
|---|---|
| LBN Legal business name | Shirley, Gwendolyn Pitcock |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 2nd, 2009 |
| Last updated | Feb 9th, 2010 - about 14 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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