Individual
SHANNON KEENAN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-7240
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
29031
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2024
Last updated
07/15/2024
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