Individual
MRS. SHANNON ELISE BRISBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2003 STULTS RD STE 100, HUNTINGTON, IN 46750-1291
(260) 356-5424
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002715A
IN
Other
Enumeration date
07/18/2019
Last updated
10/17/2022
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