Healthcare Provider Details

I. General information

NPI: 1659215242
Provider Name (Legal Business Name): AMNA ELSHIEKH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 W CAPITOL ST
JACKSON MS
39203-2605
US

IV. Provider business mailing address

628 W CAPITOL ST
JACKSON MS
39203-2605
US

V. Phone/Fax

Practice location:
  • Phone: 601-398-0066
  • Fax: 601-398-0066
Mailing address:
  • Phone: 601-398-0066
  • Fax: 601-398-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: