Individual
SANTANA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1911 GADSDEN ST, COLUMBIA, SC 29201-6400
(803) 335-5232
Mailing address
1911 GADSDEN ST, COLUMBIA, SC 29201-6400
(803) 335-5232
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
27208
SC
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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