Individual
SHANNON LILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4455 S PADRE ISLAND DR STE 13, CORPUS CHRISTI, TX 78411-5161
(361) 248-2663
(361) 356-7420
Mailing address
4455 S PADRE ISLAND DR STE 13, CORPUS CHRISTI, TX 78411-5161
(361) 248-2663
(361) 356-7420
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
781170
TX
363L00000X
Nurse Practitioner
Primary
1048576
TX
363LF0000X
Family Nurse Practitioner
1048576
TX
Other
Enumeration date
07/29/2021
Last updated
03/25/2024
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