Healthcare Provider Details

I. General information

NPI: 1275444580
Provider Name (Legal Business Name): SHANNON DAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

1305 RIDDLE FARM RD
MARSHALL NC
28753-5462
US

V. Phone/Fax

Practice location:
  • Phone: 859-382-1266
  • Fax:
Mailing address:
  • Phone: 859-382-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: