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Individual

SHANNON JEAN FOLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9748 STEPHEN DECATUR HWY STE 104, OCEAN CITY, MD 21842-9358
(410) 390-5954
Mailing address
11702 ASSATEAGUE RD, BERLIN, MD 21811-2416
(443) 235-3451

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
LP-0010585
DE
363LA2200X
Adult Health Nurse Practitioner
Primary
R140287
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0125008
PVS SECURITY CODE
DE
01
LP0010585
NURSE PRACTITIONER LICENSE
DE
01
R140287
MARYLAND LICENSE
MD
Enumeration date
10/06/2022
Last updated
12/11/2023
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