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1902116064
SHELLIE J MOFFETT
AMORY, MS
NPI
1902116064
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R855814)
Enumeration Date
2010-10-07
Last Update Date
2019-09-27
Business Address
SHELLIE J MOFFETT NP
1105 EARL FRYE BLVD
AMORY, MS 38821-5500
Phone number: 662-256-7112
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Mailing Address
SHELLIE J MOFFETT NP
10996 FOUR SEASONS PL STE 100A
CROWN POINT, IN 46307-8685
Phone number: 662-256-7112
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