Individual
LANI RENAE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
(623) 327-5859
Mailing address
11217 N 63RD AVE, GLENDALE, AZ 85304-3680
(623) 695-6478
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
277474
AZ
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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