Individual
MS. BONNIE JEAN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
37 GOODMAN RD, FORT ANN, NY 12827-5312
(860) 558-8066
Mailing address
37 GOODMAN RD, FORT ANN, NY 12827-5312
(860) 558-8066
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
536954-1
NY
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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