Provider Demographics
NPI:1295983286
Name:HANNON, SHELLEY (NP)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:
Last Name:HANNON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2550
Mailing Address - Country:US
Mailing Address - Phone:256-383-7007
Mailing Address - Fax:256-389-3353
Practice Address - Street 1:2411 AVALON AVE STE B
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3163
Practice Address - Country:US
Practice Address - Phone:256-383-7007
Practice Address - Fax:256-389-3353
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-194248363LF0000X
GARN150842363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health