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Individual

MRS. MINNIE SHIRLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1506 N MAIN ST, COLUMBIA, MS 39429-2070
(601) 736-9557
Mailing address
56 MAYFIELD RD, LAUREL, MS 39443-8459
(601) 452-0084

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905856
MS

Other

Enumeration date
03/14/2024
Last updated
03/14/2024
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