Individual
MRS. SHANNON CREEL WEATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
30 CIRCLE J DR, #1, LAUREL, MS 39440-1980
(601) 425-0092
Mailing address
527 HIGHWAY 533, LAUREL, MS 39443-8871
(601) 513-2129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R880712
MS
Other
Enumeration date
09/02/2013
Last updated
11/26/2021
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