Provider Demographics
NPI:1497525513
Name:FRANKS, SHANNON JOVAN (RN)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:JOVAN
Last Name:FRANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 ALLEN A BROWN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1153
Mailing Address - Country:US
Mailing Address - Phone:919-349-4352
Mailing Address - Fax:
Practice Address - Street 1:11601 ALLEN A BROWN RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1153
Practice Address - Country:US
Practice Address - Phone:919-349-4352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC224388163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse