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1649703919
SHANNON RILEY HERROD
LAUREL, MS
NPI
1649703919
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS 901922)
Enumeration Date
2017-04-04
Last Update Date
2017-04-04
Business Address
Mrs. SHANNON RILEY HERROD NP-C
1220 JEFFERSON ST
LAUREL, MS 39440-4355
Phone number: 601-319-8568
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Mailing Address
Mrs. SHANNON RILEY HERROD NP-C
1064 FRANCES ST
HATTIESBURG, MS 39402-8300
Phone number: 601-408-2231
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