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Individual

SHANNON HEAVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1555 ELM ST, MANCHESTER, NH 03101-1203
(603) 668-4111
Mailing address
2 WALL ST STE 300, MANCHESTER, NH 03101-1518
(603) 668-4111

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
059741-21
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
059741-23
NH

Other

Enumeration date
12/11/2006
Last updated
05/24/2019
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