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NPI Code Detail

MEDICARE: SHANNA SUZANNE ODONNELL FNP

MEDICARE: SHANNA SUZANNE ODONNELL FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner686322TX
2363LF0000XFamily Nurse PractitionerAP114865TX

General Provider Information

NPI Number : 1609887439
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNA SUZANNE ODONNELL FNP
Provider Business Mailing Address
First Line : 1016 N VIRGINIA ST
Second Line :
City : PORT LAVACA
State : TX
Zip : 77979-3000
Country : US
Telephone Number : 361-552-0325
Fax Number : 361-500-6904
Provider Business Practice Location Address
First Line : 1016 N VIRGINIA ST
Second Line :
City : PORT LAVACA
State : TX
Zip : 77979-3000
Country : US
Telephone Number : 361-552-0325
Fax Number : 361-500-6904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 06/19/2025

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Directions to “ SHANNA SUZANNE ODONNELL FNP” Practice Location

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