| NPI | 1881726271 |
|---|---|
| Former Name | SHANNON DENISE LARGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.023853) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: OH RN-253819) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-12-11 |