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General NPI Number Information
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NPI Number | 1518263888
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Entity Type | Individual
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Provider Name | BOBBY NICOLE SHOWS FNP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 6300 E LAKE BLVD STE 201
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City | VANCLEAVE
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State | MS
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Zip | 39565-6771
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Country | US
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Telephone | 228-230-2663
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Fax | 228-546-3257
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Provider Business Mailing Address
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Address Line | 6300 E LAKE BLVD STE 301
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City | VANCLEAVE
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State | MS
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Zip | 39565-6771
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Country | US
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Telephone | 228-230-2663
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Fax | 228-206-1192
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15437
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903285
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License Number State | MS
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