Heather M Shannon, NP
Nurse Practitioner, Women's Health in Fulton, NY. Individual provider (NPI-1).
NPI number1790775005
StatusActive
Last updated in NPPESOct 19, 2026
Details
- NPI
- 1790775005
- Entity type
- Individual (NPI-1)
- Name
- Heather M Shannon
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 27, 2005
- Certification date
- Oct 19, 2026
- Last updated
- Oct 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LW0102X | Nurse Practitioner, Women's Health | 00420826 | NY | Yes |
Practice location
522 S 4th St Ste 500Fulton, NY 13069
Phone 315-598-4740 · Fax 315-598-4728
Mailing address
10 George StOswego, NY 13126-3276
Phone 315-598-4715 · Fax 315-598-4751
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