| NPI | 1710386396 |
|---|---|
| Professional Name | SHANNON COSTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: ID NP-1485A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID NP-1485A) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2023-04-10 |