Individual
SHANNON KECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 MADISON AVE, MOUNT HOLLY, NJ 08060-2038
(609) 267-0700
Mailing address
15 HARROGATE CT, SEWELL, NJ 08080-2734
(609) 617-9047
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR15104200
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
25627
SC
367500000X
Certified Registered Nurse Anesthetist
26NJ00417900
NJ
Other
Enumeration date
07/17/2012
Last updated
01/17/2025
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