NPI | 1760085740 |
---|---|
Former Name | MOLLY ANN SHANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1033009) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 942518) |
Enumeration Date | 2020-11-20 |
Last Update Date | 2023-04-17 |