Mary Dee A Shanahan, LPN
Individual provider Active NPI Licensed Practical Nurse · Baraga, MI
NPI 1992882435 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992882435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 4703049546 (MI)
- Practice address
- 102 Superior Ave
Baraga, MI 49908-9673 - Phone
- (906) 353-8700
- Fax
- (906) 353-8799
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703049546 | MI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703049546 | MI | Yes |
Addresses
Primary practice location
102 Superior Ave
Baraga, MI 49908-9673
Mailing address
102 Superior Ave
Baraga, MI 49908-9673
Phone (906) 353-8700
Other providers in Baraga, MI
- Chung Oh
- Suzan Jeanne Ollila
- Thomas Penfold
- Lizabeth Ralles
- Arthur Schimelfenig
- Shelbie Anne Shelder
- Mary Margaret Tikkanen
- Darryl Tonemah
- Becky J Tussing
- Deborah Sue Vizina
All providers in Baraga, MI · Licensed Practical Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.