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Individual

DR. SHANNON M JENNINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(636) 484-0632
Mailing address
5301 FARAON ST STE 120, SAINT JOSEPH, MO 64506-3512
(816) 271-1066
(816) 271-6786

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036116552
IL
2084P0800X
Psychiatry Physician
2004001640
MO
2084P0800X
Psychiatry Physician
29302
MS
2084P0800X
Psychiatry Physician
64349
TN
2084P0800X
Psychiatry Physician
E-14709
AR
2084P0800X
Psychiatry Physician
Primary
EMC0001234
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208405506
MO
01
P00405011
RR MEDICARE INDIVIDUAL #
MO
Enumeration date
10/18/2006
Last updated
12/12/2025
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