Provider Demographics
NPI:1750402434
Name:SHAULL, JANNA BETH (RN)
Entity type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:BETH
Last Name:SHAULL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 HIGHWAY 412 W
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-5405
Mailing Address - Country:US
Mailing Address - Phone:731-968-8038
Mailing Address - Fax:
Practice Address - Street 1:295 SUMMAR DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3905
Practice Address - Country:US
Practice Address - Phone:731-421-6767
Practice Address - Fax:731-421-5148
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000120991163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health