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General NPI Number Information
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NPI Number | 1033130562
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Entity Type | Individual
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Provider Name | MARIANNE SHAUGHNESSY PH.D., CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 10 N GREENE ST BALTIMORE VA MEDICAL CENTER (BT/18/GR)
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City | BALTIMORE
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State | MD
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Zip | 21201-1524
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Country | US
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Telephone | 410-605-7000
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Fax | 410-605-7913
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Provider Business Mailing Address
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Address Line | 8 N CHESTER ST
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City | BALTIMORE
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State | MD
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Zip | 21231-1624
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Country | US
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Telephone | 410-732-3505
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Fax | 410-605-7913
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R138373
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R138373
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License Number State | MD
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