Individual
SHANNON KAY BRASIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1428 S LAPEER RD, LAKE ORION, MI 48360
(248) 693-0543
(248) 630-4301
Mailing address
PO BOX 2137, BIRMINGHAM, MI 48012-2137
(248) 693-0543
(248) 630-4301
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704180713
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528217833
NPI NUMBER
MI
Enumeration date
09/10/2008
Last updated
07/16/2018
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