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1386167799
SHANNON D RENICK
COLUMBUS, MS
NPI
1386167799
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Former Name
SHANNON D GRAHAM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: WI 7787-33)
Enumeration Date
2017-07-18
Last Update Date
2024-08-09
Business Address
Dr. SHANNON D RENICK DNP, APNP, CPNP-PC
210 INDEPENDENCE AVE
COLUMBUS, MS 39710-1269
Phone number: 662-434-1395
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Mailing Address
Dr. SHANNON D RENICK DNP, APNP, CPNP-PC
201 INDEPENDENCE
COLUMBUS, MS 39710-5300
Phone number: 624-341-3956
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