Individual
MR. SHANNON CRAIG WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
318 COFFEE AVE NE, RUSSELLVILLE, AL 35653-2331
(256) 332-1629
(256) 332-4178
Mailing address
318 COFFEE AVE NE, RUSSELLVILLE, AL 35653-2331
(256) 332-1629
(256) 332-4178
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-124327
AL
Other
Enumeration date
02/01/2010
Last updated
09/28/2011
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