Shannon, Taylor Kathryn

Shannon, Taylor Kathryn is an individual health care provider with primary practice located at 1200 N Beaver St , Flagstaff AZ 86001-3118. 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, Taylor Kathryn can be contacted via phone (928) 779-3366.

Contact Information

Primary practice address
1200 N Beaver St Flagstaff AZ 86001-3118
Phone: (928) 779-3366
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN2301626 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 319403 Arizona

Profile Details

NPI number 1407333552
LBN Legal business name Shannon, Taylor Kathryn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2018
Last updated Feb 5th, 2025 - about last year

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 1407333552 NPPES
Massachusetts MEDICAID 110164287A
Massachusetts MEDICAID 3125777

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