Shannon Sood

Individual provider Active NPI Licensed Practical Nurse · Stockbridge, MI

NPI 1558764985 · NPPES record last updated Sep 30, 2014

Key facts

NPI
1558764985
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4303089398 (MI)
Practice address
4623 Chapman Rd
Stockbridge, MI 49285-9474
Phone
(517) 610-6308
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4303089398MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4303089398 MI Yes

Addresses

Primary practice location

4623 Chapman Rd
Stockbridge, MI 49285-9474

Mailing address

4623 Chapman Rd
Stockbridge, MI 49285-9474
Phone (517) 610-6308

Other providers in Stockbridge, MI

All providers in Stockbridge, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.