SHASTA PICKENS

LAUREL, MS
NPI1679297436
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  907092)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: MS  907223)
Enumeration Date2022-09-26
Last Update Date2025-01-14
Business Address
SHASTA PICKENS
117 S 11TH AVE
LAUREL, MS 39440-4312
Phone number: 601-425-3033
Mailing Address
SHASTA PICKENS
117 S 11TH AVE
LAUREL, MS 39440-4312
Phone number: 601-425-3033