Provider Demographics
NPI:1538895628
Name:FRANCIS, SHANNON LYNN (CNP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNN
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 SILVERLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1053
Mailing Address - Country:US
Mailing Address - Phone:740-973-3818
Mailing Address - Fax:
Practice Address - Street 1:6424 SILVERLEAF AVE
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-1053
Practice Address - Country:US
Practice Address - Phone:740-973-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031984363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner