Provider Demographics
NPI:1649895673
Name:FOXX, SHANNE JONES (NP)
Entity type:Individual
Prefix:
First Name:SHANNE
Middle Name:JONES
Last Name:FOXX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 LAWYERS RD UNIT 23694
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8886
Mailing Address - Country:US
Mailing Address - Phone:980-263-7550
Mailing Address - Fax:
Practice Address - Street 1:2001 VAN HAVEN DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-4342
Practice Address - Country:US
Practice Address - Phone:980-866-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013284363LA2200X
NC241900163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator