| NPI | 1740914076 |
|---|---|
| Former Name | SHANNON CALLAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2363714) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2363714) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-10-14 |