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General NPI Number Information
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NPI Number | 1134739626
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Entity Type | Individual
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Provider Name | LILLIAN LEIGH SHANK FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/09/2020
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 232 MARKET ST
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City | FLOWOOD
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State | MS
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Zip | 39232-3339
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Provider Business Mailing Address
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Address Line | PO BOX 211699
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City | EAGAN
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State | MN
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Zip | 55121-3699
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1184853
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0103433-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024179477
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 921059
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903989
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 324448
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License Number State | AZ
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