Individual
SHANNON CRYSTAL PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11008 NEW MARKET CT, FREDERICKSBURG, VA 22407-2529
(443) 875-4058
Mailing address
11008 NEW MARKET CT, FREDERICKSBURG, VA 22407-2529
(443) 875-4058
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024181386
VA
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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