Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | R138373 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | R138373 | MD |
NPI | 1033130562 |
---|---|
Provider Name | Dr. Marianne Shaughnessy |
First Address | Baltimore, MD 21231-1624 |
Second Address | Baltimore, MD 21201-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |