| NPI | 1902275787 |
|---|---|
| Former Name | SHANNON A BURKHOLDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.18361-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 312107) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-11-10 |