Individual
AMANDA DAWN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
239 W BUSINESS 190, COPPERAS COVE, TX 76522-2912
(254) 542-9000
(254) 542-9001
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP139460
TX
Other
Enumeration date
03/08/2019
Last updated
08/22/2022
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