Individual provider · Type 1 NPI
Mary M. Shannon, CRNP
Family Nurse Practitioner · Kittanning, PA
NPI number
1104816073
Active
Practice location
1 Nolte Dr
Kittanning, PA 16201-7111
Fax (724) 543-8743
Mailing address
3530 Peach St, Suite LL1
Erie, PA 16508-2768
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | SP007840 (PA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1104816073
Mary M. Shannon, CRNP's National Provider Identifier is 1104816073, issued on Oct 24, 2005. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Kittanning, PA. The record was last updated on Jul 16, 2007.