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Individual

MRS. ANGEL V SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CRNP

Contact information

Practice address
5415 OLD COURT RD, SUITE 102, RANDALLSTOWN, MD 21133-5170
(410) 701-4600
Mailing address
9133 SUNSET RIDGE RD, RANDALLSTOWN, MD 21133-3651

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R121021
MD
363LG0600X
Gerontology Nurse Practitioner
R121021
MD

Other

Enumeration date
04/18/2013
Last updated
04/18/2013
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