Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 252262 | AZ |
NPI | 1083204069 |
---|---|
Provider Name | Shannon M Schott |
First Address | San Tan Valley, AZ 85140-5803 |
Second Address | Chandler, AZ 85226-2616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2021 |
Last Update Date | 08/07/2021 |