Individual
SHANNON JOY ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3 SLOOP LN, WAREHAM, MA 02571-1135
(508) 817-1835
Mailing address
3 SLOOP LN, WAREHAM, MA 02571-1135
(508) 817-1835
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
LN100039
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
02/07/2022
Last updated
02/07/2022
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