Individual
MRS. SHAWNTAE RENEA MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
513 ETERNAL CT, BRANDON, MS 39042-4430
(601) 706-4671
Mailing address
513 ETERNAL CT, BRANDON, MS 39042-4430
(601) 706-4671
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902508
MS
Other
Enumeration date
02/18/2018
Last updated
02/18/2018
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