Individual
SHANNON MARIE MINIHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
232 W 25TH ST, ERIE, PA 16544-0001
(814) 452-5000
Mailing address
232 W 25TH ST, ERIE, PA 16544-0002
(814) 452-5853
(814) 452-5583
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA060069
PA
Other
Enumeration date
08/01/2018
Last updated
10/05/2020
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