MEDICARE: SHANNON NICOLE HASKETT PT

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	225100000X	Physical Therapist	P7518	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B8850	OTHER	NC	MEDCOST
2	268717	OTHER	NC	MAMSI
3	078M7	OTHER	NC	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912914326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON NICOLE HASKETT PT

Provider Business Mailing Address
First Line	:	90 E MAIN ST # 1
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-3030
Country	:	US
Telephone Number	:	828-631-3009
Fax Number	:	828-354-0209

Provider Business Practice Location Address
First Line	:	90 E MAIN ST # 1
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-3030
Country	:	US
Telephone Number	:	828-550-3923
Fax Number	:	828-354-0209

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	04/11/2025

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