Search › Mississippi › 207R00000X
Shanna Pettie, M.D
NPI 1093978918 · on the registry since 2008
Practice
- Address
- 911 Ellis Ave
Jackson, MS 39209 - Phone
- (601) 533-7016
- Clinicians at this address
- 13
Additional practice sites
- 971 Lakeland Dr, Jackson, MS
- 106 Lake Vista Pl, Brandon, MS
Registry record
- Primary taxonomy
- 207R00000X
207R00000X
- Also registered as
- 171000000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-07-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi