Individual
SHELLY BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
526 DEERFIELD DR, FOREST, MS 39074-6005
(601) 469-0291
Mailing address
12953 HIGHWAY 501, FOREST, MS 39074-5647
(601) 536-3979
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R863942
MS
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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