Provider Demographics
NPI:1780422477
Name:SHANOSKY, MEGAN ROSE (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE
Last Name:SHANOSKY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-1540
Mailing Address - Fax:910-431-4048
Practice Address - Street 1:1000 BRABHAM AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5003
Practice Address - Country:US
Practice Address - Phone:910-937-2570
Practice Address - Fax:910-219-1270
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2025-02-06
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Provider Licenses
StateLicense IDTaxonomies
NC0010-14482363AM0700X
NC363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical