Provider Demographics
NPI:1598905960
Name:DOBSON, SHANNON KATHLEEN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:KATHLEEN
Last Name:DOBSON
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Gender:F
Credentials:CPNP
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Mailing Address - Street 1:2000 PROFESSIONAL WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3879
Mailing Address - Country:US
Mailing Address - Phone:770-517-0250
Mailing Address - Fax:770-517-0260
Practice Address - Street 1:2000 PROFESSIONAL WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3879
Practice Address - Country:US
Practice Address - Phone:770-517-0250
Practice Address - Fax:770-517-0260
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2011-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN112293363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics