| Doctor Name: | SHONDA JACQUELINE PHELON |
| NPI Number: | 1194947754 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.F.N.P.; P.M.H.N.P |
| License Number: | R734347 |
| Business Practice Address: | 1970 Grandview Dr Grenada, MS - 389015066 |
| Business Phone Number: | 6622273700 |
| Business Fax Number: | 6622273740 |
| Mailing Address: | Po Box 1505, GREENWOOD |
| State: | MS |
| Postal Code: | 389351505 |
| Phone Number: | 6624536211 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 02/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R734347 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |