Individual
JAIMIE ROSE JOSEPH SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3402 BATTLEGROUND AVE, GREENSBORO, NC 27410
(336) 883-0029
(336) 883-0867
Mailing address
645 N MAIN ST, HIGH POINT, NC 27260-5017
(336) 883-0029
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
5018806
NC
363LF0000X
Family Nurse Practitioner
Primary
5018806
NC
Other
Enumeration date
09/14/2023
Last updated
02/03/2025
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