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NPI Code Detail

MEDICARE: SHANOTRA ADAMS LPN

MEDICARE: SHANOTRA ADAMS LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult CompanionLCB20160000533GA
23747P1801XPersonal Care AttendantLCB20160000533GA
3376K00000XNurse's AideLCB20160000533GA

General Provider Information

NPI Number : 1063867034
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANOTRA ADAMS LPN
Provider Business Mailing Address
First Line : 207 HUDSON TRCE STE 217
Second Line :
City : AUGUSTA
State : GA
Zip : 30907-2010
Country : US
Telephone Number : 706-750-2300
Fax Number : 706-553-8241
Provider Business Practice Location Address
First Line : 207 HUDSON TRCE STE 217
Second Line :
City : AUGUSTA
State : GA
Zip : 30907-2010
Country : US
Telephone Number : 706-750-2300
Fax Number : 706-553-8241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2016
Last Update Date : 04/27/2016

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