Individual
SHEKIVA PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
98543
MS
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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