Provider Demographics
NPI:1831914589
Name:WARREN, SHANNON MARKEE (AEMT)
Entity type:Individual
Prefix:MR
First Name:SHANNON
Middle Name:MARKEE
Last Name:WARREN
Suffix:
Gender:M
Credentials:AEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 MCCAIN RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-4433
Mailing Address - Country:US
Mailing Address - Phone:901-267-8874
Mailing Address - Fax:
Practice Address - Street 1:4593 SWINNEA RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-7101
Practice Address - Country:US
Practice Address - Phone:901-292-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN209301146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate