Individual
SHANNON L CHILDERS-PAGE
Active
Individual
SHANNON L CHILDERS-PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71003354A
IN
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
28123065A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200996380
—
IN
Enumeration date
08/20/2010
Last updated
04/29/2019
Update your record
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