Shannon, Tina Nannette
Shannon, Tina Nannette is an individual health care provider with primary practice located at 3200 Maccorkle Ave Se , Charleston WV 25304-1227. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Shannon, Tina Nannette can be contacted via phone (304) 388-5503.Contact Information
Primary practice address
3200 Maccorkle Ave Se
Charleston WV 25304-1227
Phone: (304) 388-5503
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 54626 | West Virginia |
Profile Details
NPI number | 1265435556 |
---|---|
LBN Legal business name | Shannon, Tina Nannette |
Credentials | Certified Registered Nurse Anesthetist (CRNA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 31st, 2005 |
Last updated | Apr 17th, 2024 - about 5 months 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 | 1265435556 | NPPES |
West Virginia | Other | 27005299700 | WORKER'S COMP-MAAC |
West Virginia | MEDICAID | 2624413 | WORKER'S COMP-MAAC |
West Virginia | Other | 270052997 | WORKER'S COMP-MAAC |
West Virginia | MEDICAID | 2601300000 | WORKER'S COMP-MAAC |
West Virginia | Other | P00258571 | WORKER'S COMP-MAAC |
West Virginia | Other | 001713630 | WORKER'S COMP-MAAC |
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