Shanna B Pettie M.D.

NPI 1093978918 - Military Health Care Provider - 171000000X

NPI Details
NPI 1093978918
Gender Female
Enumeration Date 07/10/2008
Last Updated 06/17/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
JACKSON MS, 39216-4643, US
Phone (601) 200-4860
Fax (601) 200-4887
Business Location
PO BOX 23666
JACKSON MS, 39225-3666, US
Phone (601) 200-4749
Fax (915) 569-1919
Taxonomy Code 171000000X
License State
License Number
Remove 1093978918 NPI Number

According to our database, Dr. Shanna B Pettie M.D. NPI is 1093978918, taxonomy code is 171000000X Shanna B Pettie M.D. physically located at 971 Lakeland Dr, Jackson MS, 39216-4643. NPI Number Shanna B Pettie M.D. has the Individual type.

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1093978918 NPI number is provided on an as is basis without warranty of any kind. 1093978918 is maintained by the National Plan & Provider Enumeration System. The contents of Shanna B Pettie M.D. are for informational purposes only.