Individual
JESSICA ANN SHOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
6958 GOODMAN RD, OLIVE BRANCH, MS 38654-7034
(662) 890-5047
(662) 890-5058
Mailing address
6958 GOODMAN RD, OLIVE BRANCH, MS 38654-7034
(662) 890-5047
(662) 890-5058
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-09587
MS
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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