Individual
SHANNEN MARIE SEVERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3618 LANTANA ROAD, SUITE 200, LAKE WORTH, FL 33462-2247
(561) 968-2995
(561) 968-0203
Mailing address
3424 DIANE DR, BOYNTON BEACH, FL 33435-8554
(561) 371-9158
(561) 968-0203
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2306
FL
Other
Enumeration date
12/14/2016
Last updated
12/18/2025
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