Individual provider · Type 1 NPI

Shannon Marie McGourn, APRN

Family Nurse Practitioner · Waterbury, CT

NPI number 1104680644 Active

Practice location

1279 W Main St
Waterbury, CT 06708-3101

Mailing address

785 Old Turnpike Rd
Plantsville, CT 06479-1715

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF01241425 (CT)

Family Nurse Practitioner: Definition to come...

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About NPI 1104680644

Shannon Marie McGourn, APRN's National Provider Identifier is 1104680644, issued on Feb 6, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Waterbury, CT. The record was last updated on Mar 11, 2026.