Individual
ALISHA SHANELL MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3794 HIGHWAY 468 W, PEARL, MS 39208-9008
(601) 932-2880
Mailing address
145 MAGNOLIA WAY, PEARL, MS 39208-3366
(601) 503-7514
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903503
MS
Other
Enumeration date
04/04/2020
Last updated
04/04/2020
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