Provider Demographics
NPI:1346096856
Name:LAPORTE, SHAWNA COX (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:COX
Last Name:LAPORTE
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 1:307 FRICK LN
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-5905
Mailing Address - Country:US
Mailing Address - Phone:731-636-1513
Mailing Address - Fax:
Practice Address - Street 1:307 FRICK LN
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-5905
Practice Address - Country:US
Practice Address - Phone:731-636-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily