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Individual
MICAELA RAE SHANNON
Active
Individual
MICAELA RAE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN9469517
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11015772
FL
363LP2300X
Primary Care Nurse Practitioner
APRN11015772
FL
Other
Enumeration date
11/19/2019
Last updated
03/04/2024
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