=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497661300
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHANDRICKA DENISE SESSOM-MCGLOWN RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2026
-----------------------------------------------------
Last Update Date | 08/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6244 MS-305
-----------------------------------------------------
City | OLIVE BRANCH
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38654
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-782-5024
-----------------------------------------------------
Fax | 662-782-5025
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 145 WALL HILL RD
-----------------------------------------------------
City | BYHALIA
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38611-8504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 920259
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------