Individual
SHANNA MAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
10440 PARK RD STE 300, CHARLOTTE, NC 28210-8544
(980) 237-4766
Mailing address
10440 PARK RD STE 300, CHARLOTTE, NC 28210-8544
(980) 237-4766
(980) 404-2274
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
18070
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5913661
NC
Other
Enumeration date
11/12/2012
Last updated
07/10/2023
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