Individual
SHANNON RAE MIKITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-BC
Contact information
Practice address
11279 PERRY HWY STE 204, WEXFORD, PA 15090-9303
(724) 933-3910
Mailing address
11279 PERRY HWY STE 204, WEXFORD, PA 15090-9303
(724) 933-3910
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN609684
PA
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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