Healthcare Provider Details

I. General information

NPI: 1013012038
Provider Name (Legal Business Name): SHANNAN MICHELLE CALHOON CNM, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 W MORRIS BLVD STE A
MORRISTOWN TN
37813-2967
US

IV. Provider business mailing address

1621 W MORRIS BLVD STE A
MORRISTOWN TN
37813-2967
US

V. Phone/Fax

Practice location:
  • Phone: 423-492-7100
  • Fax:
Mailing address:
  • Phone: 423-492-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number11029P
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1681
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number27154
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: