Individual provider · Type 1 NPI
Heather M. Shannon, NP
Women's Health Nurse Practitioner · Fulton, NY
NPI number
1790775005
Active
Practice location
522 S 4th St Ste 500
Fulton, NY 13069
Fax (315) 598-4728
Mailing address
10 George St
Oswego, NY 13126-3276
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Women's Health Nurse Practitioner Primary | 363LW0102X | 00420826 (NY) |
Women's Health Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1790775005
Heather M. Shannon, NP's National Provider Identifier is 1790775005, issued on Oct 27, 2005. The primary taxonomy on file is Women's Health Nurse Practitioner (363LW0102X), and the practice location is in Fulton, NY. The record was last updated on Oct 19, 2026.