Individual
MRS. SHANNON RILEY HERROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 319-8568
(601) 426-4228
Mailing address
1064 FRANCES ST, HATTIESBURG, MS 39402-8300
(601) 408-2231
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901922
MS
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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