Blake, Shannon

Blake, Shannon is an individual health care provider with primary practice located at 631 Quaker Ln S , West Hartford CT 06110-1026. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Blake, Shannon can be contacted via phone (860) 233-5133.

Contact Information

Primary practice address
631 Quaker Ln S West Hartford CT 06110-1026
Phone: (860) 233-5133
Fax: (860) 232-6527
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 001550 Connecticut

Profile Details

NPI number 1578509238
LBN Legal business name Blake, Shannon
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jul 28th, 2011 - about 15 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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