Provider Demographics
NPI:1679887921
Name:THROWER, SHAWNA L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:L
Last Name:THROWER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 RETAIL DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-7353
Mailing Address - Country:US
Mailing Address - Phone:919-761-1002
Mailing Address - Fax:
Practice Address - Street 1:12000 RETAIL DR
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-7353
Practice Address - Country:US
Practice Address - Phone:919-761-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily