NPI | 1013347665 |
---|---|
Former Name | SHANNON M MCGINITY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 100410) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-RN-LIC-71603) |
363LF0000X Nurse Practitioner, Family (Licence: CO 0990549) | |
Enumeration Date | 2013-11-19 |
Last Update Date | 2015-12-03 |