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1336786144
SHANNON MICHAEL GENNETTE
SAN JOSE, CA
NPI
1336786144
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95012678)
Enumeration Date
2019-11-30
Last Update Date
2019-11-30
Business Address
SHANNON MICHAEL GENNETTE
751 S BASCOM AVE
SAN JOSE, CA 95128-2699
Phone number: 408-885-2454
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Mailing Address
SHANNON MICHAEL GENNETTE
751 S BASCOM AVE
SAN JOSE, CA 95128-2699
Phone number: 408-885-2454
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