Individual
MRS. MELISSA CHASE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
210 S CAMERON ST, HILLSBOROUGH, NC 27278-2505
(919) 732-9311
Mailing address
1600 PERIMETER PARK DR, SUITE #225, MORRISVILLE, NC 27560-8421
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
02-647371
CT
363LF0000X
Family Nurse Practitioner
052782
MA
363LF0000X
Family Nurse Practitioner
101-0021041
VT
363LF0000X
Family Nurse Practitioner
Primary
241346
NC
363LF0000X
Family Nurse Practitioner
87166
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05319758
BLUE SHIELD
VT
05
—
ONP0290
—
VT
Enumeration date
05/29/2011
Last updated
05/22/2013
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