Individual
KYLE PATRICK SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 567-4311
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 445-1588
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11034132
FL
363L00000X
Nurse Practitioner
APRN.CNP.023482
OH
363LF0000X
Family Nurse Practitioner
11034132
FL
Other
Enumeration date
07/18/2018
Last updated
05/19/2025
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