| Doctor Name: | SHANNON CREGEUR DARKET |
| NPI Number: | 1588052864 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 4704291576 |
| Business Practice Address: | 2240 Winrow Ave Usa Meddac, Rwbahc Fort Huachuca, AZ - 85613 |
| Business Phone Number: | 7348344096 |
| Business Fax Number: | |
| Mailing Address: | 2839 Greenbrier Rd, SIERRA VISTA |
| State: | AZ |
| Postal Code: | 856505601 |
| Phone Number: | 7348344096 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2015 |
| NPI Last Update Date: | 01/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 4704291576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |