Individual
MICHAEL A SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2815 CATES AVE CB 7304, RALEIGH, NC 27695-7304
(919) 515-2563
(888) 972-4151
Mailing address
2815 CATES AVE CB 7304, RALEIGH, NC 27695-7304
(919) 515-2563
(888) 972-4151
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
960046
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003831
—
NC
Enumeration date
08/16/2006
Last updated
07/24/2024
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