Individual
SHANNON M KINNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
515 S 26TH ST, OMAHA, NE 68105-4101
(402) 552-6007
(402) 552-6247
Mailing address
515 S. 26TH ST., OMAHA, NE 68131
(402) 553-6007
(402) 552-6247
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5679
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5679
TEP
NE
Enumeration date
09/07/2007
Last updated
09/07/2007
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