Individual
SHANNON HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
10 N GREENE ST, BALTIMORE, MD 21201-1524
(410) 605-7000
Mailing address
7111 NEWBERRY DR, COLUMBIA, MD 21044-4217
(410) 935-1088
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R157026
MD
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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