Individual
SHANNON CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1626 NE 105TH ST, MIAMI SHORES, FL 33138-2118
(786) 877-8732
Mailing address
1626 NE 105TH ST, MIAMI SHORES, FL 33138-2118
(786) 877-8732
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11038638
FL
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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