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Individual

ROBIN SUE SHANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
420 MAIN ST STE 15, WALPOLE, MA 02081-3753
(508) 660-1666
(508) 660-1667
Mailing address
420 MAIN ST STE 15, WALPOLE, MA 02081-3753
(508) 660-1666
(508) 660-1667

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5006766
NC
363LF0000X
Family Nurse Practitioner
5006766
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2326129
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518383223
NC
05
NP4339
SC
Enumeration date
03/06/2014
Last updated
10/10/2019
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