Individual
SHANNON KASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3011
(585) 922-4518
(585) 336-5113
Mailing address
4993 TIM TAM TRL, BLASDELL, NY 14219-2633
(716) 998-1405
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
307673
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
307673
NY
Other
Enumeration date
03/09/2016
Last updated
12/04/2019
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