Healthcare Provider Details

I. General information

NPI: 1194689778
Provider Name (Legal Business Name): COURTNEY SHAMBREE RHODES CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 FELTON DR
MILLEDGEVILLE GA
31061-7718
US

IV. Provider business mailing address

125 FELTON DR
MILLEDGEVILLE GA
31061-7718
US

V. Phone/Fax

Practice location:
  • Phone: 706-543-9677
  • Fax: 706-621-5921
Mailing address:
  • Phone: 706-543-9677
  • Fax: 706-621-5921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberCN0030081272
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberCN0030081272
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberCN0030081272
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCN0030081272
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: