Provider Demographics
NPI:1861843435
Name:MANDERS, SHEENA POWELL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:POWELL
Last Name:MANDERS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2399 PARKLAND DR NE UNIT 1121
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-7039
Mailing Address - Country:US
Mailing Address - Phone:727-239-5577
Mailing Address - Fax:
Practice Address - Street 1:5455 MERIDIAN MARKS RD STE 130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4722
Practice Address - Country:US
Practice Address - Phone:404-255-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2022-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA7986363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant