Individual
SHANNON WHITTEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN53322
RI
363L00000X
Nurse Practitioner
Primary
APRN01618
RI
Other
Enumeration date
05/11/2017
Last updated
02/13/2018
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