Individual
JILL MARIE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
356 W CHERRY ST, ACKERMAN, MS 39735-8709
(662) 285-3243
Mailing address
PO BOX 1327, STARKVILLE, MS 39760-1327
(662) 285-3243
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R753944
MS
Other
Enumeration date
08/20/2008
Last updated
06/30/2011
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