Individual
SHANTA BLAKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
169 S MCCRARY RD, COLUMBUS, MS 39702-6319
(662) 630-5181
Mailing address
169 S MCCRARY RD, COLUMBUS, MS 39702-6319
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MS
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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