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Individual

SHANNON JOAN CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1448 RICHARDSON ST, BALTIMORE, MD 21230-5322
(301) 648-4545
Mailing address
1448 RICHARDSON ST, BALTIMORE, MD 21230-5322
(301) 648-4545

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R198017
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R198017
REGISTERED NURSE LICENSE
MD
Enumeration date
07/01/2019
Last updated
09/04/2024
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