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General NPI Number Information
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NPI Number | 1073305066
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Entity Type | Individual
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Provider Name | SHANNON WILLIAMS-COCHRAN
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 2004 CARVER DR
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City | FORT VALLEY
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State | GA
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Zip | 31030-4443
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Country | US
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Telephone | 478-718-8793
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 CARVER DR
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City | FORT VALLEY
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State | GA
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Zip | 31030-4443
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Country | US
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Telephone | 478-718-8793
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163WE0900X
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Taxonomy Name | Enterostomal Therapy Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | LPN096721
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License Number State | GA
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Taxonomy #11
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN096721
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License Number State | GA
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Taxonomy #12
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number | LPN096721
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License Number State | GA
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