Individual
SHANNON VINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2670 MCINGVALE RD STE H, HERNANDO, MS 38632-8695
(662) 429-4988
(662) 298-2186
Mailing address
7271 ALLISON RD, OLIVE BRANCH, MS 38654-9203
(901) 292-4992
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
889627
MS
363LF0000X
Family Nurse Practitioner
Primary
901618
MS
Other
Enumeration date
07/11/2016
Last updated
11/14/2018
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