SHANE BANNON

PHILADELPHIA, PA
NPI1245997220
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: PA  SP024901)
Enumeration Date2021-11-24
Last Update Date2021-11-24
Business Address
SHANE BANNON
1 CONVENTION AVE
PHILADELPHIA, PA 19104-4311
Phone number: 800-789-7366
Mailing Address
SHANE BANNON
285 BIRCH DR
LAFAYETTE HILL, PA 19444-2103
Phone number:
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