Individual
SHANNON AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 SOUTH BLVD, CHARLOTTE, NC 28203-4215
(704) 334-8087
Mailing address
4136 WOODGREEN TER, CHARLOTTE, NC 28205-4666
(703) 389-2063
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5012130
NC
363LF0000X
Family Nurse Practitioner
R231979
MD
Other
Enumeration date
03/10/2018
Last updated
11/01/2022
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