Individual
DONITA G SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
188 MILLPOND DR, HATTIESBURG, MS 39401-5561
(601) 405-9013
Mailing address
188 MILLPOND DR, HATTIESBURG, MS 39401-5561
(601) 405-9013
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MS
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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