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1043851587
SHADA BREEZE TENNYSON
TUPELO, MS
NPI
1043851587
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS 903537)
Enumeration Date
2019-10-07
Last Update Date
2023-11-14
Business Address
SHADA BREEZE TENNYSON FNP-C
1018 N GLOSTER ST
TUPELO, MS 38804-1297
Phone number: 662-523-4950
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Mailing Address
SHADA BREEZE TENNYSON FNP-C
1018 N GLOSTER ST
TUPELO, MS 38804-1297
Phone number: 662-523-4950
Copy
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