| NPI | 1518716828 |
|---|---|
| Former Name | SHANNON BETH CUMMINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021511) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 306080) |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |