Individual
SHAWNNA JANE GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6546 WHITE SPRUCE AVE, BRASELTON, GA 30517-6257
(615) 477-9527
Mailing address
6546 WHITE SPRUCE AVE, BRASELTON, GA 30517-6257
(615) 477-9527
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006202
GA
363AS0400X
Surgical Physician Assistant
Primary
006202
GA
363AS0400X
Surgical Physician Assistant
PA0000000778
TN
Other
Enumeration date
05/02/2007
Last updated
02/24/2021
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