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NPI Code Detail

MEDICARE: SHALUNDA HARRISON

MEDICARE:   SHALUNDA  HARRISON
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
1164W00000XLicensed Practical NurseLPN078786GA

General Provider Information

NPI Number : 1700495975
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALUNDA HARRISON
Provider Business Mailing Address
First Line : 4311 CHRISTINE CT
Second Line :
City : DECATUR
State : GA
Zip : 30035-1702
Country : US
Telephone Number : 470-651-0956
Fax Number :
Provider Business Practice Location Address
First Line : 4311 CHRISTINE CT
Second Line :
City : DECATUR
State : GA
Zip : 30035-1702
Country : US
Telephone Number : 470-651-0956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2020
Last Update Date : 12/09/2021

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Directions to “ SHALUNDA HARRISON ” Practice Location

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