Search › Mississippi › 363LW0102X
Blanche Petty, APRN
NPI 1932509833 · on the registry since 2014 · sole proprietor
Practice
- Address
- 730 Goodman Rd E Ste B
Southaven, MS 38671 - Phone
- (662) 649-6087
- Organisation at this address
- Shay Wellness, Llc
De Soto Smiles Family DentistryInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 363LW0102X
363LW0102X
- Also registered as
- 363LX0001X
- Licence states on file
- TN, MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-09-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi