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Individual
RYAN SHANNON
Active
Individual
RYAN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
1-159336
AL
363LG0600X
Gerontology Nurse Practitioner
Primary
1-159336
AL
363LP2300X
Primary Care Nurse Practitioner
1-159336
AL
Other
Enumeration date
10/02/2020
Last updated
09/03/2026
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