Individual
SHANNON DESMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3024 NEW BERN AVE # 102, RALEIGH, NC 27610-1247
(919) 350-7331
Mailing address
5121 STAVERLY LN, NORCROSS, GA 30092-1786
(770) 655-2145
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN257653
GA
367500000X
Certified Registered Nurse Anesthetist
725367
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
725367
NC
Other
Enumeration date
08/28/2021
Last updated
10/24/2024
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