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1467445924
SHANNON K IDZIK
BALTIMORE, MD
NPI
1467445924
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Former Name
SHANNON K REEDY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: MD R131534)
Enumeration Date
2005-08-30
Last Update Date
2011-01-10
Business Address
-- SHANNON K IDZIK CRNP
655 W LOMBARD ST 345
BALTIMORE, MD 21201-1512
Phone number: 410-706-8129
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Mailing Address
-- SHANNON K IDZIK CRNP
655 W LOMBARD ST 345
BALTIMORE, MD 21201-1512
Phone number: 410-706-8129
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