| NPI | 1598479263 |
|---|---|
| Former Name | SHANNON MARIE MILLIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186040) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 112192) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |