| NPI | 1982025680 |
|---|---|
| Former Name | SHANNON JO MCDONNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C154146) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C154146) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IA C154146) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 217536-0) | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2019-09-05 |