Provider Demographics
NPI:1750779617
Name:HOLBROOK, SHANEL SOLEE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHANEL
Middle Name:SOLEE
Last Name:HOLBROOK
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:SHANEL
Other - Middle Name:DEKENA
Other - Last Name:SOLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3158 FREEDOM DR STE 3102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-0014
Mailing Address - Country:US
Mailing Address - Phone:704-971-7099
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:3158 FREEDOM DR STE 3101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-0014
Practice Address - Country:US
Practice Address - Phone:704-348-2992
Practice Address - Fax:704-971-0035
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7664363LF0000X
UT7017694-4405363LF0000X
NC5015376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily