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Individual

KATHLEEN SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
940 BELMONT ST, VA BOSTON HEALTHCARE SYSTEM, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
9 MARTHA AVE, SWANSEA, MA 02777-1617
(508) 675-7708

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
894
MA

Other

Enumeration date
09/21/2006
Last updated
07/08/2007
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