Individual
MRS. GRETCHEN S. SHULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2500 N STATE ST, UNIVERSITY PHYSICIANS, JACKSON, MS 39216-4500
(601) 815-1384
(601) 815-3322
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 622-1744
(601) 622-1744
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R870219
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00672357
—
MS
Enumeration date
12/07/2009
Last updated
10/27/2016
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