| NPI | 1427719657 |
|---|---|
| Former Name | SHANNON MALLORY KEEGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016157) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11016157) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2025-07-23 |