Individual
DR. SHANNA SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP-APRN
Contact information
Practice address
11100 OLD HWY 64 W, BOLIVAR, TN 38008
(901) 300-6808
Mailing address
9245 POPLAR AVE STE 368, GERMANTOWN, TN 38138-7931
(901) 300-6808
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26359
TN
Other
Enumeration date
09/26/2019
Last updated
10/22/2024
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