Individual
SHELLIE J MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1105 EARL FRYE BLVD, AMORY, MS 38821-5500
(662) 256-7112
(662) 256-7116
Mailing address
10996 FOUR SEASONS PL, STE 100A, CROWN POINT, IN 46307-8685
(662) 256-7112
(662) 256-7116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855814
MS
Other
Enumeration date
10/07/2010
Last updated
09/27/2019
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