Individual provider · Type 1 NPI
Shane Bannon
Acute Care Nurse Practitioner · Philadelphia, PA
NPI number
1245997220
Active
Practice location
1 Convention Ave
Philadelphia, PA 19104-4311
Mailing address
285 Birch Dr
Lafayette Hill, PA 19444-2103
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | SP024901 (PA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1245997220
Shane Bannon's National Provider Identifier is 1245997220, issued on Nov 24, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 24, 2021.