Individual
SHAWANDA NECHELLA AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7736 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 772-5222
(662) 772-5957
Mailing address
3629 WILLIAMS BROOKE LN, HERNANDO, MS 38632-6793
(662) 401-3380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24203
MS
207Q00000X
Family Medicine Physician
61110
TN
207Q00000X
Family Medicine Physician
L.4005R
AL
Other
Enumeration date
05/29/2014
Last updated
03/22/2024
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