Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN079156 | GA |
NPI | 1144378498 |
---|---|
Provider Name | Shawn M Hitchcock |
First Address | Atlanta, GA 30308-2247 |
Second Address | Atlanta, GA 30308-2247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 08/07/2007 |