Healthcare Provider Details

I. General information

NPI: 1972932002
Provider Name (Legal Business Name): NAOMI SHOWS AGNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 01/28/2024
Certification Date: 01/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SIMPSON HIGHWAY 149 STE 220
MAGEE MS
39111-3847
US

IV. Provider business mailing address

555 EUGIE PALMER RD
MENDENHALL MS
39114-8997
US

V. Phone/Fax

Practice location:
  • Phone: 601-849-1530
  • Fax: 601-849-1535
Mailing address:
  • Phone: 692-294-6487
  • Fax: 14-397-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR878234
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: