Individual
SHANTELL WASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 203-1146
Mailing address
240 NORTH AVE NE APT 1206, ATLANTA, GA 30308-2497
(404) 203-1146
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN330267
GA
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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