Holthaus, Shannon Marie

Holthaus, Shannon Marie is an individual health care provider with primary practice located at 1802 S Mattis Ave , Champaign IL 61821-5923. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Holthaus, Shannon Marie can be contacted via phone (217) 383-3260.

Contact Information

Primary practice address
1802 S Mattis Ave Champaign IL 61821-5923
Phone: (217) 383-3260
Fax: (217) 383-4459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.011667 Illinois

Profile Details

NPI number 1558779058
LBN Legal business name Holthaus, Shannon Marie
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2014
Last updated May 26th, 2015 - about 11 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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