Individual
SHANNON HENNESSY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1301 FAYETTEVILLE ST, DURHAM, NC 27707-2325
(919) 956-4000
Mailing address
4609 PLEASANT GROVE CHURCH RD, RALEIGH, NC 27613-3323
(919) 510-4474
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
149601
NC
Other
Enumeration date
04/05/2013
Last updated
09/29/2023
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