Individual
SHANA C PROFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
845 MALCOLM BLVD, CONNELLY SPRINGS, NC 28612
(828) 580-3555
(828) 874-2111
Mailing address
845 MALCOLM BLVD, CONNELLY SPRINGS, NC 28612
(828) 580-3555
(828) 874-2111
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
202133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407109309
—
NC
Enumeration date
10/17/2012
Last updated
03/17/2018
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