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Individual

SHANNON MARIE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
12588 W DAKOTA AVE APT 203, LAKEWOOD, CO 80228-2533
(417) 763-8683

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
1698886
CO
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95392615
CA

Other

Enumeration date
03/29/2025
Last updated
04/04/2025
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