Gulley, Shannon
Gulley, Shannon is an individual health care provider with primary practice located at 425 E Dahlia Ave Ste J , Palmer AK 99645-6463. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Gulley, Shannon can be contacted via phone (907) 746-1520.Contact Information
Primary practice address
425 E Dahlia Ave Ste J
Palmer AK 99645-6463
Phone: (907) 746-1520
Fax: (907) 746-1521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MEDS8191 | Alaska |
Profile Details
| NPI number | 1336116821 |
|---|---|
| LBN Legal business name | Gulley, Shannon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Feb 3rd, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336116821 | NPPES |
| Montana | MEDICAID | 0157403 |
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