Provider Demographics
NPI:1871176412
Name:FERRARI, SHANNON LEE (MSN, RN-BC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LEE
Last Name:FERRARI
Suffix:
Gender:F
Credentials:MSN, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CLERMONT DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1643
Mailing Address - Country:US
Mailing Address - Phone:201-657-4623
Mailing Address - Fax:
Practice Address - Street 1:106 CLERMONT DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1643
Practice Address - Country:US
Practice Address - Phone:201-657-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0046496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse