| NPI | 1154567675 |
|---|---|
| Former Name | SHANNON MARIE MACDONALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ00867800) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP010097) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2018-12-18 |