Healthcare Provider Details

I. General information

NPI: 1851659635
Provider Name (Legal Business Name): SHANNON CURRY KEARL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHANNON KATHLEEN CURRY M.D.

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD
PHOENIX AZ
85016-7710
US

IV. Provider business mailing address

3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2327
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-0777
  • Fax:
Mailing address:
  • Phone: 602-933-1813
  • Fax: 602-933-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number123456
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number50423
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: