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NPI Code Detail

MEDICARE: CASHENA SHAUNTE VANN NP

MEDICARE: CASHENA SHAUNTE VANN 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
1363LF0000XFamily Nurse Practitioner231683NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1231683OTHERNCNC MEDICAL LICENSE

General Provider Information

NPI Number : 1831752492
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASHENA SHAUNTE VANN NP
Provider Business Mailing Address
First Line : PO BOX 7200
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-0200
Country : US
Telephone Number : 252-937-0300
Fax Number : 252-937-3108
Provider Business Practice Location Address
First Line : 921 N WINSTEAD AVE
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-8749
Country : US
Telephone Number : 252-937-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2019
Last Update Date : 05/01/2019

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