Individual
SHANNON CREEDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3488 DEPEW AVE, PORT CHARLOTTE, FL 33952-7015
(941) 764-7923
Mailing address
47 BRIGGSBORO LN, FAIRPORT, NY 14450-3805
(315) 507-1878
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686564
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11014376
FL
Other
Enumeration date
09/22/2015
Last updated
07/30/2021
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