Individual
SHANNON HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4040 S EASTERN AVE, LAS VEGAS, NV 89119-0810
(702) 463-0300
Mailing address
12759 EPPERLY ST, HENDERSON, NV 89044-1073
(609) 424-7017
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
857220
NV
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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