Individual
SHANNON CAVEDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 326-3555
Mailing address
3258 GREENLEAFE DR, PHOENIX, NY 13135-1539
(315) 391-3242
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
388737
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401603
NY
Other
Enumeration date
05/29/2013
Last updated
01/17/2014
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