Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 11029P | VI |
N | 176B00000X | Midwife | 1681 | CA |
NPI | 1013012038 |
---|---|
Provider Name | Mrs. Shannan Michelle Calhoon |
First Address | Morristown, TN 37813-2967 |
Second Address | Morristown, TN 37813-2967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 30/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0087580 | (05) | CA |
Q063261 | (05) | TN |