Healthcare Provider Details

I. General information

NPI: 1497661300
Provider Name (Legal Business Name): SHANDRICKA DENISE SESSOM-MCGLOWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANDRICKA SESSOM RN

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6244 MS-305
OLIVE BRANCH MS
38654
US

IV. Provider business mailing address

145 WALL HILL RD
BYHALIA MS
38611-8504
US

V. Phone/Fax

Practice location:
  • Phone: 662-782-5024
  • Fax: 662-782-5025
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number920259
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: