| NPI | 1083693717 |
|---|---|
| Former Name | KATIE E SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-45804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2001023150) |
| 363L00000X Nurse Practitioner (Licence: KS 53-45804) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2022-03-04 |