Provider Demographics
NPI:1710180682
Name:EUBANKS, SHANNON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:SHOCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:411 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-8150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 CENTERVIEW DR
Practice Address - Street 2:SUITE 390
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3226
Practice Address - Country:US
Practice Address - Phone:615-661-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10102183500000X, 1835P0018X, 1835P1300X, 1835P2201X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care