Provider Demographics
NPI:1972198554
Name:HERRING, SHANNON RICE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:RICE
Last Name:HERRING
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3870
Mailing Address - Country:US
Mailing Address - Phone:770-812-8541
Mailing Address - Fax:770-812-8561
Practice Address - Street 1:523 DIXIE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3870
Practice Address - Country:US
Practice Address - Phone:770-812-8541
Practice Address - Fax:770-812-8561
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135487363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health