Church, Shannon L.

Church, Shannon L. is an individual health care provider with primary practice located at 271 Carew St , Springfield MA 01104-2377. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Church, Shannon L. can be contacted via phone (413) 748-9349.

Contact Information

Primary practice address
271 Carew St Springfield MA 01104-2377
Phone: (413) 748-9349
Fax: (413) 452-6080
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA3911 Massachusetts

Profile Details

NPI number 1164750105
LBN Legal business name Church, Shannon L.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2009
Last updated May 18th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164750105 NPPES
Massachusetts Other PA3911 MA PA LICENSE

Popular Providers