Doctor Name: | SHANNON KAY JARAMILLO |
NPI Number: | 1124307186 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP4015 |
Business Practice Address: | 12262 E Bradshaw Mountain Rd #2 Dewey, AZ - 863276032 |
Business Phone Number: | 9287721673 |
Business Fax Number: | |
Mailing Address: | 12262 E Bradshaw Mountain Rd, #2 DEWEY |
State: | AZ |
Postal Code: | 863276032 |
Phone Number: | 9287721673 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2011 |
NPI Last Update Date: | 08/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP4015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |