Warren, Shannon R

Warren, Shannon R is an individual health care provider with primary practice located at 1542 Medical Park Cir , Tupelo MS 38801-6560. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Warren, Shannon R can be contacted via phone (662) 844-4711.

Contact Information

Primary practice address
1542 Medical Park Cir Tupelo MS 38801-6560
Fax: (662) 844-9619
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R867515 Mississippi

Profile Details

NPI number 1497800833
LBN Legal business name Warren, Shannon R
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
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 1497800833 NPPES
Mississippi MEDICAID APPLIED FOR

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