MEDICARE: SHANNON ANN MAJORS SRNA

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	163W00000X	Registered Nurse	258728	NC

General Provider Information

NPI Number	:	1780381160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON ANN MAJORS SRNA

Provider Business Mailing Address
First Line	:	2260 HOUSECREEK TRL APT 104
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-3487
Country	:	US
Telephone Number	:	704-608-0383
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 HOUSECREEK TRL APT 104
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-3487
Country	:	US
Telephone Number	:	704-608-0383
Fax Number	:

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

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	02/15/2023

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