Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101267589 | VA |
Y | 208600000X | Surgeon | 0101267589 | VA |
N | 208200000X | Surgeon | MD60090634 | WA |
N | 208600000X | Surgeon | MD60090634 | WA |
N | 2086X0206X | Surgical Oncologist | 249543 | NY |
NPI | 1003020660 |
---|---|
Provider Name | Dr. Shannon N Tierney |
First Address | Fishersville, VA 22939-0388 |
Second Address | Fishersville, VA 22939-2273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003020660 | (05) | VA |