| NPI | 1083673545 |
|---|---|
| Former Name | SHANNON KATHRYN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS 903276) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-06-13 |