Individual
MRS. SHANICE THURMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2201 TALMADGE RD, HAMPTON, GA 30228-1608
(404) 564-7005
Mailing address
6558 ROSWELL RD APT 1168, ATLANTA, GA 30328-5071
(414) 698-9920
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
9934
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/24/2019
Last updated
03/10/2021
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