Blanche Foshee' Petty, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

109301 Issued in MS

Practice address

730 Goodman Rd E Ste B
Southaven, MS 38671-9530

Phone

(662) 649-6087

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: blanche@shaywellness.kareodirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shay Wellness, LLC

  • Women's Health Nurse Practitioner
  • Southaven, MS
  • NPI 1477489987
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1932509833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 GOODMAN RD E STE B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-649-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GOODMAN RD E STE B",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719530",
            "telephone_number": "662-649-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "BLANCHE",
        "middle_name": "FOSHEE'",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TN",
            "license": "18870",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MS",
            "license": "109301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Grace Pena, PTA
• Jennifer Petell, PH.D IN CLINICAL PSY
• Calleen Patricia Petersen, LMSW
• John S Petrides
• Tracey F Petrides, M.D.
• Pharmcare USA of Memphis, Inc
• Phase2 Labs Mississippi LLC
• Phillips County Transportation
• Galen Phillips, NP
• Samantha Phillips, COTA/L

• Women's Health Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Women's Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.