Individual
SHANNON MILLER ULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
489 WASHINGTON AVE, CLARKSBURG, WV 26301-2825
(304) 622-2708
Mailing address
13 EASTERN TRL, MORGANTOWN, WV 26508-5991
(845) 863-5504
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
106952
WV
Other
Enumeration date
07/31/2020
Last updated
09/10/2020
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