Provider Demographics
NPI:1154480432
Name:NEWMAN, SHANNON CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:CHRISTOPHER
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:ANN
Other - Last Name:CHRISTOPHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:264 HUNTERS LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-264-0955
Mailing Address - Fax:
Practice Address - Street 1:370 OLD SHACKLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-824-0720
Practice Address - Fax:615-824-0272
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist