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Individual

SHONNA DICKARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(663) 377-4164
Mailing address
830 S GLOSTER ST, TUPELO, MS 38801-4934

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R882768
MS

Other

Enumeration date
02/27/2014
Last updated
02/27/2014
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