Healthcare Provider Details

I. General information

NPI: 1295770220
Provider Name (Legal Business Name): SHANNON A YARBROUGH N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON A PRUITT NP

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 INTERNATIONAL PARK DR STE 250
BIRMINGHAM AL
35243-4217
US

IV. Provider business mailing address

6 EAGLES FAIR
GADSDEN AL
35905-8847
US

V. Phone/Fax

Practice location:
  • Phone: 205-730-7980
  • Fax: 205-730-7980
Mailing address:
  • Phone: 256-557-2651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN132591
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-096078
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: