Individual
SHAQUITA SAMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1134 WINTER ST, JACKSON, MS 39204-2841
(601) 948-5572
Mailing address
559 HEATHERWOOD DR, JACKSON, MS 39212-4707
(769) 262-7650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN884677
MS
Other
Enumeration date
10/24/2014
Last updated
12/03/2024
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