Individual
SHANNON BRADY-POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
925 CHESTNUT ST, SIXTH FLOOR, PHILADELPHIA, PA 19107-4216
(215) 955-6760
(215) 923-4532
Mailing address
925 CHESTNUT ST, 6TH FLOOR, PHILADELPHIA, PA 19107-4216
(215) 955-6760
(215) 923-4532
Taxonomy
Speciality
Code
Description
License number
State
163WX0601X
Otorhinolaryngology & Head-Neck Registered Nurse
RN536907
PA
363L00000X
Nurse Practitioner
Primary
SP009125
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102879964
—
PA
Enumeration date
08/27/2007
Last updated
02/21/2018
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