| NPI | 1043971625 |
|---|---|
| Former Name | SYDNEY LEA SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 202200281NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202002535RN) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2025-01-13 |