Doctor Name: | STEPHANIE ANNE MEIER SHANNON |
NPI Number: | 1285978718 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | A-113993 |
Business Practice Address: | 1795 Highway 64 E Anamosa, IA - 522052112 |
Business Phone Number: | 3194626131 |
Business Fax Number: | |
Mailing Address: | 9935 Ginger Rdg, DUBUQUE |
State: | IA |
Postal Code: | 520018226 |
Phone Number: | 5635821918 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2012 |
NPI Last Update Date: | 11/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A-113993 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |