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1376918862
SHANNON PROFANCHIK
COPPELL, TX
NPI
1376918862
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP129425)
Enumeration Date
2015-12-09
Last Update Date
2015-12-09
Business Address
-- SHANNON PROFANCHIK
546 E SANDY LAKE RD
COPPELL, TX 75019-5786
Phone number: 972-393-8067
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Mailing Address
-- SHANNON PROFANCHIK
546 E SANDY LAKE RD
COPPELL, TX 75019-5786
Phone number: 972-393-8067
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