Individual
SHANNON M RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
345 VIGUE RD, WHITEFIELD, ME 04353-3013
(207) 215-2092
Mailing address
345 VIGUE RD, WHITEFIELD, ME 04353-3013
(207) 215-2092
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN52456
ME
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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