Healthcare Provider Details

I. General information

NPI: 1265803399
Provider Name (Legal Business Name): SHANNON GAIL MILLSAPS RN, MSN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON MILLSAPS LANG

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 GREAT CIRCLE RD FL 3
NASHVILLE TN
37228-1317
US

IV. Provider business mailing address

501 GREAT CIRCLE RD FL 3
NASHVILLE TN
37228-1317
US

V. Phone/Fax

Practice location:
  • Phone: 888-605-9060
  • Fax:
Mailing address:
  • Phone: 888-605-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0040335
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5008025
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5008025
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5008025
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number33626
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number158203
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71017247A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704439024
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: