Healthcare Provider Details

I. General information

NPI: 1528857034
Provider Name (Legal Business Name): SHANNON ELIZABETH ALLMANN-BENOIT APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N GOULD ST STE 64226
SHERIDAN WY
82801-6317
US

IV. Provider business mailing address

1505 CORNERSTONE CT
BEAUMONT TX
77706-3899
US

V. Phone/Fax

Practice location:
  • Phone: 307-395-9355
  • Fax:
Mailing address:
  • Phone: 409-219-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number1199573
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number6871953
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number59235
License Number StateWY
# 4
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number243170
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberARNP.AP.70121561-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: