Thedford, Shana
Thedford, Shana is an sole proprietor health care provider with primary practice located at 3126 8Th St. Magnolia Plaza Suite A., Meridian MS 39301-3930. She recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Contact Lens, Eye and Vision Services Providers / Ophthalmic Assistant, Eye and Vision Services Providers / Ocularist, Eye and Vision Services Providers / Optician, Agencies / Voluntary or Charitable. Eye and Vision Services Providers / Ophthalmic Assistant is her primary health care specialty. Thedford, Shana can be contacted via phone (601) 207-5085.Contact Information
Primary practice address
3126 8Th St. Magnolia Plaza Suite A.
Meridian MS 39301-3930
Phone: (601) 207-5085
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Contact Lens | 156FC0800X | Mississippi | |
| Eye and Vision Services Providers / Ophthalmic Assistant | 156FX1101X | Mississippi | |
| Eye and Vision Services Providers / Ocularist | 156FX1700X | ||
| Eye and Vision Services Providers / Optician | 156FX1800X | Mississippi | |
| Eye and Vision Services Providers / Optician | 156FX1800X | ||
| Agencies / Voluntary or Charitable | 251V00000X | ||
| Eye and Vision Services Providers / Ophthalmic Assistant | 156FX1101X |
Profile Details
| NPI number | 1790289510 |
|---|---|
| LBN Legal business name | Thedford, Shana |
| Credentials | RO |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2018 |
| Last updated | Sep 1st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790289510 | NPPES |
| Mississippi | MEDICAID | 05986512 | |
| Mississippi | Other | 16999022 |
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