Individual
SHANNON MARIE SCANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
701 PLEASANT ST, GRAND LEDGE, MI 48837-1344
(254) 258-2584
Mailing address
701 PLEASANT ST, GRAND LEDGE, MI 48837-1344
(254) 258-2584
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2022008174
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022008174
FAMILY NURSE PRACTITIONER CERTIFICATION
MI
Enumeration date
08/23/2022
Last updated
08/23/2022
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