Individual
DR. MARY ANN SHINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ACNP, CNS
Contact information
Practice address
1110 ARNO DR, SIERRA MADRE, CA 91024-1511
(626) 991-2912
Mailing address
1110 ARNO DR, SIERRA MADRE, CA 91024-1511
(626) 991-2912
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
8478
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8478
CALIFORNIA NP FURNISHING NUMBER
CA
Enumeration date
09/26/2019
Last updated
09/26/2019
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