MEDICARE: SHANNON CHRISTIE NP

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
1	363LF0000X	Family Nurse Practitioner	RN186831	GA

General Provider Information

NPI Number	:	1144648395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON CHRISTIE NP

Provider Business Mailing Address
First Line	:	4514 CHAMBLEE DUNWOODY RD
Second Line	:	#328
City	:	ATLANTA
State	:	GA
Zip	:	30338-6272
Country	:	US
Telephone Number	:	678-205-0491
Fax Number	:	770-685-6848

Provider Business Practice Location Address
First Line	:	725 N CENTRAL AVE
Second Line	:
City	:	HAPEVILLE
State	:	GA
Zip	:	30354-1935
Country	:	US
Telephone Number	:	404-761-2766
Fax Number	:	770-685-6848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2014
Last Update Date	:	12/10/2025

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Directions to “ SHANNON CHRISTIE NP” Practice Location

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