Individual
SHAQUILLE ALEXIS MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
702 W MAIN ST, TUPELO, MS 38804-3734
(662) 840-4818
Mailing address
702 W MAIN ST, TUPELO, MS 38804-3734
(662) 840-4818
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
900717
MS
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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