Individual
JEANETTE M SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
53 GIBSON RD, GOSHEN, NY 10924-6709
(845) 291-0200
Mailing address
53 GIBSON RD, GOSHEN, NY 10924-6709
(845) 291-0200
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
689372
NY
Other
Enumeration date
07/20/2019
Last updated
07/20/2019
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