Healthcare Provider Details

I. General information

NPI: 1801726930
Provider Name (Legal Business Name): SHANNON LOZITO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

133 LAKE RAPONDA RD
WILMINGTON VT
05363-9794
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone: 802-258-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number026.0152412
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5025346
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: