Individual
MICHAEL SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1015 E 6TH AVE, ANCHORAGE, AK 99501-2748
(907) 276-6430
Mailing address
1015 E 6TH AVE, ANCHORAGE, AK 99501-2748
(907) 276-6430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
152821
AK
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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