Provider Demographics
NPI:1972932002
Name:SHOWS, NAOMI (AGNP, FNP)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SHOWS
Suffix:
Gender:F
Credentials:AGNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 EUGIE PALMER RD
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-8997
Mailing Address - Country:US
Mailing Address - Phone:692-294-6487
Mailing Address - Fax:014-397-2896
Practice Address - Street 1:360 SIMPSON HIGHWAY 149 STE 220
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3847
Practice Address - Country:US
Practice Address - Phone:601-849-1530
Practice Address - Fax:601-849-1535
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR878234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty