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Individual

SHANNON CHRISTIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
196 W MEADOW LN SW, CONYERS, GA 30012-6427
(770) 679-1079
(470) 207-7140
Mailing address
196 W MEADOW LN SW, CONYERS, GA 30012-6427
(770) 679-1079

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2931437
AMERICAN MEDICAL TECHNOLOGISTS
GA
Enumeration date
11/15/2022
Last updated
11/15/2022
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