Provider Demographics
NPI:1902435381
Name:FOREE, SHAUNDRA RENEE (RN,BSN,CCM)
Entity Type:Individual
Prefix:
First Name:SHAUNDRA
Middle Name:RENEE
Last Name:FOREE
Suffix:
Gender:F
Credentials:RN,BSN,CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 SILVER WAY
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3956
Mailing Address - Country:US
Mailing Address - Phone:404-664-0757
Mailing Address - Fax:877-366-6214
Practice Address - Street 1:1730 SILVER WAY
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3956
Practice Address - Country:US
Practice Address - Phone:404-664-0757
Practice Address - Fax:877-366-6214
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA182859163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management