Individual
SHANNON BROOKE DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6750 E BROADWAY RD, MESA, AZ 85206-1700
(480) 756-6789
Mailing address
109 N BARKLEY, MESA, AZ 85203-8933
(602) 930-5648
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
321242
AZ
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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