Individual
MRS. CHANDELLE EILENE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3265 FIVE POINTS DR STE A, AUBURN HILLS, MI 48326-2337
(248) 609-1234
(248) 290-9643
Mailing address
3265 FIVE POINTS DR, AUBURN HILLS, MI 48326-2337
(248) 609-1234
(248) 290-9643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011252
MI
363AM0700X
Medical Physician Assistant
1191042
MI
Other
Enumeration date
08/25/2022
Last updated
02/08/2023
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