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Individual
SHANNON LEIGH NICHOLSON
Active
Individual
SHANNON LEIGH NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024167932
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457507717
—
VA
Enumeration date
08/18/2008
Last updated
06/21/2012
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