Search › Mississippi › 1041C0700X
Shannon Church, LCSW
NPI 1164767778 · on the registry since 2012
Practice
- Address
- 1340 Broad Ave
Ste 410
Gulfport, MS 39501 - Phone
- (228) 867-5202
- Fax
- (228) 867-5007
- Organisation at this address
- Tbd Acquisition Ii Llc
Abha Mishra Neurology Pllc
The Medical Oncology Group
Memorial Hospital At Gulfport
Memorial Hospital At GulfportInferred from a shared address, not stated in the registry. - Clinicians at this address
- 81
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- MS, LA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-12-07
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