Fullen-Roberts, Shannon

Fullen-Roberts, Shannon is an individual health care provider with primary practice located at 16000 Johnston Memorial Dr Suite 212A, Abingdon VA 24211-7664. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fullen-Roberts, Shannon can be contacted via phone (276) 258-3740.

Contact Information

Primary practice address
16000 Johnston Memorial Dr Suite 212A Abingdon VA 24211-7664
Phone: (276) 258-3740
Fax: (276) 258-3745
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 25249 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024171744 Virginia

Profile Details

NPI number 1245645118
LBN Legal business name Fullen-Roberts, Shannon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2014
Last updated Mar 13th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245645118 NPPES
Virginia Other P01696407 RAILROAD MEDICARE
Virginia MEDICAID Q024051 RAILROAD MEDICARE
Virginia MEDICAID 1245645118 RAILROAD MEDICARE

Popular Providers