Provider Demographics
NPI:1427117175
Name:STOKES, SHANNON T (FNP)
Entity type:Individual
Prefix:MISS
First Name:SHANNON
Middle Name:T
Last Name:STOKES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003
Mailing Address - Country:US
Mailing Address - Phone:803-245-2433
Mailing Address - Fax:803-245-7424
Practice Address - Street 1:526 NORTH ST
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003
Practice Address - Country:US
Practice Address - Phone:803-245-2433
Practice Address - Fax:803-245-7424
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily