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Individual

MARY M SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1 NOLTE DR, KITTANNING, PA 16201-7111
(724) 543-8536
(724) 543-8743
Mailing address
3530 PEACH ST, SUITE LL1, ERIE, PA 16508-2768

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP007840
PA

Other

Enumeration date
10/24/2005
Last updated
07/16/2007
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