| NPI | 1548786213 |
|---|---|
| Former Name | LESLIE SUE SHANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 905747) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3011633) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2023-05-26 |