Individual
ALICE SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
971 LAKELAND DR STE 950, JACKSON, MS 39216-4608
(601) 362-6900
(601) 362-6111
Mailing address
PO BOX 296, BENTON, MS 39039-0296
(769) 234-8311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905551
MS
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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