Individual
CHERYL LYNN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3615 NW SAMARITAN DR STE 201, CORVALLIS, OR 97330-3771
(541) 768-5930
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
202211114NP-PP
OR
Other
Enumeration date
08/02/2022
Last updated
12/22/2022
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