Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shanna Shackelford, DNP-APRN

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1720639172

Dr. Shanna Shackelford, DNP-APRN is a Nurse Practitioner in Bolivar, Tennessee. Qualified in 2019, 7 years ago. Accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
7
Licensed in
TN
In the registry since
2019

Practice location Address checks out

11100 Old Hwy 64 W
Bolivar, TN 38008
Phone: (901) 300-6808
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26359 (TN)

Record details

NPI number1720639172
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP-APRN
Sole proprietorNo
NPI enumeratedSeptember 26, 2019
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bolivar