Provider Demographics
NPI:1548294325
Name:ROSS, SHANNON JEAN (PA-C, M-PAS)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:JEAN
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA-C, M-PAS
Other - Prefix:MISS
Other - First Name:SHANNON
Other - Middle Name:JEAN
Other - Last Name:DOOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MPAS
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-0777
Mailing Address - Country:US
Mailing Address - Phone:724-736-3330
Mailing Address - Fax:
Practice Address - Street 1:3459 5TH AVE
Practice Address - Street 2:UPMC STARZL TRANSPLANT INSTITUTE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3236
Practice Address - Country:US
Practice Address - Phone:412-647-5752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051572363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant