Provider Demographics
NPI:1417843665
Name:JOYCE, SHANNON BROOKE
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:BROOKE
Last Name:JOYCE
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 1:153 E GRAYCREST AVE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1513
Mailing Address - Country:US
Mailing Address - Phone:615-598-3978
Mailing Address - Fax:615-598-3978
Practice Address - Street 1:153 E GRAYCREST AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-1513
Practice Address - Country:US
Practice Address - Phone:615-598-3978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program