IndividualActive
Alice Shackelford, FNP-C
NPI 1316653397 · Family Nurse Practitioner · Jackson, MS
Provider details
- NPI number
- 1316653397
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- License
- 905551 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
971 Lakeland Dr Ste 950
Jackson, MS 39216-4608
Phone: (601) 362-6900
Fax: (601) 362-6111
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 296
Benton, MS 39039-0296
Registry dates
- Enumerated
- 2023-01-24
- Last updated
- 2023-01-24
- Certified
- 2023-01-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.