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Individual

SHANNON WILSON HENSLEE

Active
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Individual

SHANNON WILSON HENSLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPA, MSED, ATC, PA-C

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126000585
VA
363AM0700X
Medical Physician Assistant
0010-03506
NC
363AM0700X
Medical Physician Assistant
0110003302
VA
363AM0700X
Medical Physician Assistant
Primary
10732
GA

Other

Enumeration date
02/24/2006
Last updated
01/18/2022
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