| NPI | 1679064695 |
|---|---|
| Former Name | SHANNON E DONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.023459) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-11-20 |