Grass, Shannon Sue

Grass, Shannon Sue is an individual health care provider with primary practice located at 22395 Edgewater Dr , Port Charlotte FL 33980-2012. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Grass, Shannon Sue can be contacted via phone (941) 766-7222.

Contact Information

Primary practice address
22395 Edgewater Dr Port Charlotte FL 33980-2012
Phone: (941) 766-7222
Fax: (941) 766-0970
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2014003270 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN9205247 Florida

Profile Details

NPI number 1427247790
LBN Legal business name Grass, Shannon Sue
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2007
Last updated Oct 24th, 2022 - about 2 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 1427247790 NPPES
Florida MEDICAID 254016906

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