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SHANNON DAWN COFFEE FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1932650173
Individual Registrant: SHANNON DAWN COFFEE FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1005 BOULDER DR GRAY, GA 31032 US
Tel: 478-621-2100 Fax: 478-744-0481
Tel: 478-621-2100 Fax: 478-744-0481
Contact information for business:
1005 BOULDER DR GRAY, GA 31032-6141 US
Tel: 478-621-2100 Fax: 478-744-0481
Tel: 478-621-2100 Fax: 478-744-0481
Registration Information:
NPI: 1932650173
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | GA | RN149671 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
