Provider Demographics
NPI:1184514366
Name:SEBOURNE-FRANCIS, SHAHANA
Entity type:Individual
Prefix:
First Name:SHAHANA
Middle Name:
Last Name:SEBOURNE-FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 RAVENCLIFF DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168
Mailing Address - Country:US
Mailing Address - Phone:203-892-7190
Mailing Address - Fax:
Practice Address - Street 1:2610 RAVENCLIFF DRIVE
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168
Practice Address - Country:US
Practice Address - Phone:203-892-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty