Individual
MISS SHANNON KIRSTEN WEBSTER
Active
Individual
MISS SHANNON KIRSTEN WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
5601005506
MI
363AM0700X
Medical Physician Assistant
Primary
5601005506
MI
Other
Enumeration date
06/15/2010
Last updated
10/31/2019
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