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NPI Code Detail

MEDICARE: AMANDA SHANNON

MEDICARE:   AMANDA  SHANNON
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
1171R00000XInterpreterGA

General Provider Information

NPI Number : 1194684985
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SHANNON
Provider Business Mailing Address
First Line : 100 FLAT CREEK DR
Second Line :
City : MONROE
State : GA
Zip : 30655-6332
Country : US
Telephone Number : 404-444-5476
Fax Number :
Provider Business Practice Location Address
First Line : 100 FLAT CREEK DR
Second Line :
City : MONROE
State : GA
Zip : 30655-6332
Country : US
Telephone Number : 404-444-5476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ AMANDA SHANNON ” Practice Location

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