Individual
SHANNON KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1301 VETERANS MEMORIAL BLVD, EUPORA, MS 39744-2064
(662) 258-7200
Mailing address
1238 TURNER RD, MABEN, MS 39750-9141
(662) 418-6708
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
904206
MS
Other
Enumeration date
11/18/2020
Last updated
02/16/2026
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