Individual
TONYA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4560 METHODIST HOME RD, JACKSON, MS 39213-4201
(601) 927-0188
(601) 292-7998
Mailing address
PO BOX 2305, CLINTON, MS 39060-2305
(601) 927-0188
(601) 292-7998
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
866136
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02551264
—
MS
Enumeration date
10/20/2021
Last updated
10/20/2021
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