Healthcare Provider Details

I. General information

NPI: 1770346090
Provider Name (Legal Business Name): SHANTE R FINCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 E COCKRELL ST
NASHVILLE NC
27856-1625
US

IV. Provider business mailing address

217 N LUMBER ST
NASHVILLE NC
27856-1729
US

V. Phone/Fax

Practice location:
  • Phone: 252-904-5624
  • Fax:
Mailing address:
  • Phone: 252-904-5623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number9907874
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: