Individual provider · Type 1 NPI

Ardis Christopher Shannon

Driver · Suffolk, VA

NPI number 1508628777 Active

Practice location

4522 Marlin Ave
Suffolk, VA 23435-2377

Call (757) 641-1876 Map

Mailing address

4522 Marlin Avenue, Suffolk, Va, Usa
Suffolk, VA 23435-2377

Specialties and licenses

TaxonomyCodeLicense
Secured Medical Transport (VAN) 343800000X243944436 (MS)
Non-emergency Medical Transport (VAN) 343900000X243944436 (MS)
Driver Primary 172A00000X243944436 (MS)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1508628777

Ardis Christopher Shannon's National Provider Identifier is 1508628777, issued on Jan 24, 2024. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Suffolk, VA. The record was last updated on Feb 22, 2024.