Individual
SHANE WHEELUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
550 PEACHTREE ST NE DEPT OF, ATLANTA, GA 30308-2247
(404) 686-4411
Mailing address
3094 SAWGRASS TRL SW, LILBURN, GA 30047-1861
(770) 310-0756
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN182869
GA
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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