Individual provider · Type 1 NPI
Ian Shannon
Nurse Practitioner · Rochester, NY
Practice location
601 Elmwood Ave Fl 3
Rochester, NY 14642-0001
Mailing address
601 Elmwood Ave
Rochester, NY 14642-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 312441 (NY) |
| Registered Nurse | 163W00000X | 795387 (NY) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1679461818
Ian Shannon's National Provider Identifier is 1679461818, issued on Jun 26, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Rochester, NY. The record was last updated on Aug 22, 2025.