Individual
SHANNON A WENDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
43 NEW SCOTLAND AVE # B4, ALBANY, NY 12208-3412
(518) 262-9200
Mailing address
43 NEW SCOTLAND AVE, ALBANY, NY 12208-3412
(518) 262-9200
(518) 262-8984
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
382136
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382136
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02909497
—
NY
Enumeration date
07/06/2010
Last updated
09/14/2020
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