Healthcare Provider Details

I. General information

NPI: 1558295329
Provider Name (Legal Business Name): SHANNON LEIGH DRECHSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7689 SANDY FARM RD
SEVERN MD
21144-1118
US

IV. Provider business mailing address

7689 SANDY FARM RD
SEVERN MD
21144-1118
US

V. Phone/Fax

Practice location:
  • Phone: 410-916-7478
  • Fax:
Mailing address:
  • Phone: 410-916-7478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR236460
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: