Provider Demographics
NPI:1386292910
Name:LOMASNEY, SHANNON NICOLE
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:NICOLE
Last Name:LOMASNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PINEGATE CIR APT 12
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2265
Mailing Address - Country:US
Mailing Address - Phone:586-960-6082
Mailing Address - Fax:
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-323-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156F00000X
NCP0176191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No156F00000XEye and Vision Services ProvidersTechnician/Technologist