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General NPI Number Information
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NPI Number | 1285342329
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Entity Type | Individual
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Provider Name | SHANNON M ELROD NP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 7547 MEDICAL DR STE 1300
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City | GLOUCESTER
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State | VA
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Zip | 23061-4388
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Country | US
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Telephone | 804-695-8550
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Fax | 804-695-8554
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Provider Business Mailing Address
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Address Line | 7919 RIVERSIDE DR
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City | GLOUCESTER
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State | VA
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Zip | 23061-4722
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Country | US
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Telephone | 757-617-0954
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024180659
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License Number State | VA
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