Individual
SHANNON MCCRILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-5610
Mailing address
3 ROGERS LN, KITTERY, ME 03904-1115
(207) 752-6177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
07/24/2023
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