Healthcare Provider Details

I. General information

NPI: 1922919398
Provider Name (Legal Business Name): SHAMARIA SINGLETON-SPANN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 MCDONALD DR APT B3
CLINTON MS
39056-5302
US

IV. Provider business mailing address

606 MCDONALD DR APT B3
CLINTON MS
39056-5302
US

V. Phone/Fax

Practice location:
  • Phone: 601-573-3376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number908791
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: