Cornell, Shannon

Cornell, Shannon is an individual health care provider with primary practice located at 115 N Sumter St Ste 410 , Sumter SC 29150-4969. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Cornell, Shannon can be contacted via phone (803) 774-9797.

Contact Information

Primary practice address
115 N Sumter St Ste 410 Sumter SC 29150-4969
Phone: (803) 774-9797
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APN.0991755-NP Colorado
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 22165 South Carolina

Profile Details

NPI number 1679951990
LBN Legal business name Cornell, Shannon
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2015
Last updated Oct 29th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679951990 NPPES
South Carolina MEDICAID NP5392

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