Individual
MRS. SHANNON RENAE WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 HIGHWAY 28 W, BELLE, MO 65013-3405
(573) 859-3775
(573) 859-3997
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 761-7246
(573) 761-6947
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
155084
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619033404
—
MO
Enumeration date
12/28/2006
Last updated
09/28/2012
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