Healthcare Provider Details

I. General information

NPI: 1679931877
Provider Name (Legal Business Name): SHATUANA MCGEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 DOVE TREE LN
RALEIGH NC
27610-6693
US

IV. Provider business mailing address

3206 DOVE TREE LN
RALEIGH NC
27610-6693
US

V. Phone/Fax

Practice location:
  • Phone: 919-441-4463
  • Fax:
Mailing address:
  • Phone: 919-441-4463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: