| Doctor Name: | SHONNA PRUITT DAVIS |
| NPI Number: | 1699177634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC |
| License Number: | R857213 |
| Business Practice Address: | 3550 Highway 468 W Whitfield, MS - 391935529 |
| Business Phone Number: | 6013518000 |
| Business Fax Number: | 6013518586 |
| Mailing Address: | 3550 Highway 468 W, P.o. Box 1 Fiscal Service WHITFIELD |
| State: | MS |
| Postal Code: | 391935529 |
| Phone Number: | 6013518000 |
| Fax Number: | 6013518586 |
| NPI Enumeration Date: | 09/22/2014 |
| NPI Last Update Date: | 09/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | R857213 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |