Shellie A Burks, CFNP
Individual provider Active NPI Family Nurse Practitioner · Corinth, MS
NPI 1790940237 · NPPES record last updated Jul 24, 2008
Key facts
- NPI
- 1790940237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R716626 (MS)
- Practice address
- 1001 S Harper Rd
Corinth, MS 38834-6646 - Phone
- (662) 286-1499
- Fax
- (662) 286-9041
- NPI assigned
- Jul 24, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R716626 | MS | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R716626 | MS | Yes |
Addresses
Primary practice location
1001 S Harper Rd
Corinth, MS 38834-6646
Mailing address
1001 S Harper Rd
Corinth, MS 38834-6646
Phone (662) 286-1499
Other providers in Corinth, MS
- Jeni Bullard
- Cheryl Burcham
- Kaycee Renee Burcham
- Teesha Maye Burcham
- Lisa Burdge
- Meghan L Butler
- George Leonard Cain Jr.
- Sherry D. Callahan
- Lauren Canaan
- Ryan Canaan
All providers in Corinth, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.