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1245914027
SHANNON MCCRILLIS
PORTLAND, ME
NPI
1245914027
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2023-06-13
Last Update Date
2023-07-24
Business Address
SHANNON MCCRILLIS PA
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-662-5610
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Mailing Address
SHANNON MCCRILLIS PA
3 ROGERS LN
KITTERY, ME 03904-1115
Phone number: 207-752-6177
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