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General NPI Number Information
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NPI Number | 1215748306
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Entity Type | Individual
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Provider Name | SHANNON MCCONKEY CPNP-AC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 2929 WOODLAND PARK DR
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City | HOUSTON
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State | TX
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Zip | 77082-2687
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Country | US
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Telephone | 281-293-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 10007 BORDLEY DR
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City | HOUSTON
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State | TX
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Zip | 77042-2003
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Country | US
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Telephone | 713-213-5112
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Fax |
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 1179071
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License Number State | TX
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