MEDICARE: SHANNON S PASCHAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	374J00000X	Doula	NC
2	253Z00000X	In Home Supportive Care Agency	NC
3	175T00000X	Peer Specialist
4	311ZA0620X	Adult Care Home Facility	NC

General Provider Information

NPI Number	:	1598507154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON S PASCHAL

Provider Business Mailing Address
First Line	:	5517 TWIN BROOK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269
Country	:	US
Telephone Number	:	980-234-9317
Fax Number	:

Provider Business Practice Location Address
First Line	:	5517 TWIN BROOK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269
Country	:	US
Telephone Number	:	980-234-9317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/04/2026

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Directions to “ SHANNON S PASCHAL ” Practice Location

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