Shannon, Chaunta Wade

Shannon, Chaunta Wade is an sole proprietor health care provider with primary practice located at 1090 Eagles Brooke Dr , Locust Grove GA 30248-2475. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Shannon, Chaunta Wade can be contacted via phone (419) 610-3721.

Contact Information

Primary practice address
1090 Eagles Brooke Dr Locust Grove GA 30248-2475
Phone: (419) 610-3721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 325286 Mississippi

Profile Details

NPI number 1831940741
LBN Legal business name Shannon, Chaunta Wade
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2024
Last updated Mar 28th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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