Individual
DR. SHANNON CHRISTINE AGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV NEUROLOGY PEDIATRICS, STE 2130, SAINT LOUIS, MO 63110-1002
(314) 454-6120
(314) 454-4225
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6120
(314) 454-4225
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2018021584
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059179
—
MO
Enumeration date
07/05/2013
Last updated
04/15/2025
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