Chaunta Wade Shannon
NPI #1831940741 in Locust Grove, Georgia
Provider Information
- NPI Number
- 1831940741
- Entity Type
- Individual
- Name
- Chaunta Wade Shannon
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Mar 28, 2024
- Last Updated
- Mar 28, 2024
Practice Location
- Address
- 1090 EAGLES BROOKE DR
- City
- Locust Grove
- State
- Georgia
- ZIP Code
- 30248-2475
- Phone
- (419) 610-3721
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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