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General NPI Number Information
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NPI Number | 1699267351
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Entity Type | Individual
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Provider Name | SONYA DUBOSE SHAHEED FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 2121 FOUNTAIN DR STE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-2900
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Country | US
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Telephone | 770-736-3008
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Fax | 770-687-2296
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Provider Business Mailing Address
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Address Line | 2121 FOUNTAIN DR STE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-2900
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Country | US
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Telephone | 770-736-3008
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Fax | 770-687-2296
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | RN215968
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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 | RN215968
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | RN215968
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License Number State | GA
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