Individual
SHANNON LEE RAKITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 662-3487
Mailing address
329 KESWICK DR, WOOLWICH TOWNSHIP, NJ 08085-2541
(856) 693-4416
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP032917
PA
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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