| NPI | 1013184266 |
|---|---|
| Former Name | SHANNA A MCCAMMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005617) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: KY 3005617) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3005617) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2018-08-03 |