Individual
SHANNON DAWN EDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
103775
IA
363LN0000X
Neonatal Nurse Practitioner
Primary
K103775
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831152834
—
IA
Enumeration date
04/10/2006
Last updated
02/13/2024
Update your record
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