Individual
MISS SHANNON L GHIZZONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1211 DUBLIN RD, COLUMBUS, COLUMBUS, OH 43215-1091
(614) 486-5200
(614) 486-9665
Mailing address
1211 DUBLIN RD, COLUMBUS, COLUMBUS, OH 43215-1091
(614) 486-5200
(614) 486-9665
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50-002605
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0213174
—
OH
01
—
31-1425166
FEDERAL TAX ID
—
Enumeration date
12/14/2006
Last updated
08/26/2025
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