Individual
SHANNON SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(804) 827-9357
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024185350
VA
Other
Enumeration date
09/23/2022
Last updated
04/08/2026
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