Individual
SHANNON S DANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 330-3688
(812) 355-3270
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 330-3688
(812) 355-3270
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000249A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201273190
—
IN
Enumeration date
10/06/2006
Last updated
01/18/2016
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