Provider Demographics
NPI:1093524761
Name:L SHANNA C HOOPER
Entity type:Organization
Organization Name:L SHANNA C HOOPER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LSHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-622-0603
Mailing Address - Street 1:925 S KERR AVE STE E4
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4335
Mailing Address - Country:US
Mailing Address - Phone:910-622-0603
Mailing Address - Fax:910-782-8002
Practice Address - Street 1:925 S KERR AVE STE E4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4335
Practice Address - Country:US
Practice Address - Phone:910-622-0603
Practice Address - Fax:910-782-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health