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General NPI Number Information
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NPI Number | 1174800072
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Entity Type | Individual
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Provider Name | SHASHANK KUMAR JHA MBBS, FNP, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 2550 SANDY PLAINS RD STE 225
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City | MARIETTA
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State | GA
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Zip | 30066-7256
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Country | US
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Telephone | 770-525-7415
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Fax |
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Provider Business Mailing Address
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Address Line | 445 WINN WAY
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City | DECATUR
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State | GA
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Zip | 30030-1707
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Country | US
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Telephone | 404-508-3835
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN214076
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17634
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN214076
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License Number State | GA
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