Individual provider · Type 1 NPI

Shannon Dre Chisholm, PA-C

Physician Assistant · Daytona Beach, FL

NPI number 1700824638 Active

Practice location

595 N Williamson Blvd
Daytona Beach, FL 32114-7185

Call (872) 231-3162 Map

Fax (702) 977-1496

Mailing address

PO Box 7410884
Chicago, IL 60674-0884

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XPA02625 (TX)
Physician Assistant Primary 363A00000XPA9107966 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1700824638

Shannon Dre Chisholm, PA-C's National Provider Identifier is 1700824638, issued on Jun 3, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Daytona Beach, FL. The record was last updated on Oct 3, 2025.