Individual
MRS. SHANNON KATHLEEN JAMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1408
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022171
ANTHEM
ME
01
—
3584883
AETNA
ME
05
—
410770099
—
ME
Enumeration date
09/02/2005
Last updated
08/27/2026
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