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NPI Code Detail

MEDICARE: SHANNON G SHULER MS,FNP,CEN

MEDICARE: SHANNON G SHULER MS,FNP,CEN
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN113834GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700876695
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON G SHULER MS,FNP,CEN
Provider Business Mailing Address
First Line : 58 BIG A ROAD
Second Line :
City : TOCCOA
State : GA
Zip : 30577-6000
Country : US
Telephone Number : 706-886-3148
Fax Number : 706-886-2945
Provider Business Practice Location Address
First Line : 58 BIG A ROAD
Second Line :
City : TOCCOA
State : GA
Zip : 30577-6000
Country : US
Telephone Number : 706-886-3148
Fax Number : 706-886-2945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 06/13/2013

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