Individual
JESSICA NICOLE WALLACE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
910 MARY VANCE DR, TUPELO, MS 38801-6226
(662) 767-4200
Mailing address
1211 S GLOSTER ST STE A, TUPELO, MS 38801-6548
(662) 767-4200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901492
MS
363LA2200X
Adult Health Nurse Practitioner
901492
MS
Other
Enumeration date
04/19/2016
Last updated
07/25/2025
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