Individual
SHANNON CARRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 GREENTREE CENTER, SUITE 117, MARLTON, NJ 08053-3422
(609) 484-0106
Mailing address
3100 17TH ST STE A, SAINT CLOUD, FL 34769-6021
(407) 892-0009
(407) 892-3285
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9117419
FL
363AM0700X
Medical Physician Assistant
PA9114719
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2021
Last updated
05/16/2024
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