Individual
MS. SHANNON MARIE NANSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 512-1574
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
(208) 625-2070
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/16/2018
Last updated
03/21/2022
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