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Individual
SARA SHANAHAN COFFEE
Active
Individual
SARA SHANAHAN COFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
821450
CA
163W00000X
Registered Nurse
L1-0042630
DE
163W00000X
Registered Nurse
RN642361
PA
363L00000X
Nurse Practitioner
Primary
95016924
CA
363LP0200X
Pediatric Nurse Practitioner
95016924
CA
363LP0200X
Pediatric Nurse Practitioner
RN235660
GA
Other
Enumeration date
05/30/2013
Last updated
08/10/2023
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