Organization
SHANNON PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN SHANNON FNP, PMHNP (OWNER)
(617) 858-1833
Entity
Organization
Contact information
Practice address
6 LIBERTY SQUARE, PMB 311, BOSTON, MA 02109
(617) 858-1833
Mailing address
6 LIBERTY SQUARE, PMB 311, BOSTON, MA 02109
(617) 858-1833
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518383223
NPI - INDIVIDUAL
—
Enumeration date
07/02/2021
Last updated
07/08/2021
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