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Organization
BEAUTIFUL MINDS MENTAL HEALTH SERVICES
Active
Organization
BEAUTIFUL MINDS MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNA SHACKELFORD DNP (APRN, PMHNP)
(901) 300-6808
Entity
Organization
Contact information
Practice address
11100 OLD HWY 64, BOLIVAR, TN 38008
(901) 300-6808
Mailing address
PO BOX 25013, MEMPHIS, TN 38125-8001
(901) 300-6808
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/11/2022
Last updated
09/19/2023
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