Healthcare Provider Details

I. General information

NPI: 1588614283
Provider Name (Legal Business Name): SHANNA YVONNE PRESSLEY PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNA YVONNE HARVEL PA

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 TURNER MCCALL BLVD SW
ROME GA
30161-6070
US

IV. Provider business mailing address

11766 HIGHWAY 27 # 1
SUMMERVILLE GA
30747-5989
US

V. Phone/Fax

Practice location:
  • Phone: 706-728-3240
  • Fax:
Mailing address:
  • Phone: 706-857-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA877
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA877
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number12322
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: