Individual provider · Type 1 NPI

Shannon Willis

Student in an Organized Health Care Education/Training Program · Greensboro, NC

NPI number 1700745692 Active

Practice location

1121 N Church St
Greensboro, NC 27401-1007

Call (336) 832-3358 Map

Mailing address

8200 Joe Jessup Ct
Greensboro, NC 27455-9355

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X239107 (NC)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1700745692

Shannon Willis's National Provider Identifier is 1700745692, issued on Jan 17, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Greensboro, NC. The record was last updated on Jan 17, 2026.