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General NPI Number Information
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NPI Number | 1649136219
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Entity Type | Individual
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Provider Name | SHANNON WHEELER RN
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1120 MARS HILL RD STE 215
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City | WATKINSVILLE
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State | GA
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Zip | 30677-4800
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Country | US
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Telephone | 770-466-7771
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Fax | 770-466-3810
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Provider Business Mailing Address
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Address Line | 1423 CLAY RD
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City | MONTICELLO
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State | GA
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Zip | 31064-7521
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Country | US
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Telephone | 770-466-7771
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Fax | 770-466-3810
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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 | RN155523
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License Number State | GA
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