Nicholson, Shannon Leigh

Nicholson, Shannon Leigh is an individual health care provider with primary practice located at 19455 Deerfield Ave Suite 312, Lansdowne VA 20176-8100. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Nicholson, Shannon Leigh can be contacted via phone (703) 729-5010.

Contact Information

Primary practice address
19455 Deerfield Ave Suite 312 Lansdowne VA 20176-8100
Phone: (703) 729-5010
Fax: (703) 729-5833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024167932 Virginia

Profile Details

NPI number 1457507717
LBN Legal business name Nicholson, Shannon Leigh
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2008
Last updated Jun 21st, 2012 - about 12 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 1457507717 NPPES
Virginia MEDICAID 1457507717

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