| Doctor Name: | SHANNON R. MOTT |
| NPI Number: | 1003095381 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R858671 |
| Business Practice Address: | 25117 Highway 15 Union, MS - 393659088 |
| Business Phone Number: | 6017748214 |
| Business Fax Number: | 6017748379 |
| Mailing Address: | Po Box 2106, MERIDIAN |
| State: | MS |
| Postal Code: | 393022106 |
| Phone Number: | 6017034282 |
| Fax Number: | 6017034597 |
| NPI Enumeration Date: | 11/02/2007 |
| NPI Last Update Date: | 01/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R858671 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |