Healthcare Provider Details

I. General information

NPI: 1568816221
Provider Name (Legal Business Name): ASHLEY SHELBY DEES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

112 MARBLEHEAD DR
BRANDON MS
39047-8293
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-2538
  • Fax:
Mailing address:
  • Phone: 601-984-1934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number901488
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number901488
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: