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1780149153
SHANNON LYN MANLEY
OAKLAND, CA
NPI
1780149153
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Former Name
SHANNON JORDAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95010607)
Enumeration Date
2019-02-09
Last Update Date
2019-02-28
Business Address
SHANNON LYN MANLEY FNP-BC
3900 PIEDMONT AVE
OAKLAND, CA 94611-5352
Phone number: 415-432-7899
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Mailing Address
SHANNON LYN MANLEY FNP-BC
3400 DATA DR ATTN: CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 95670-7956
Phone number:
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