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General NPI Number Information
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NPI Number | 1285715847
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Entity Type | Individual
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Provider Name | SHANNON M JENNINGS M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1501 S POTOMAC ST
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City | AURORA
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State | CO
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Zip | 80012-5411
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Country | US
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Telephone | 636-484-0632
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 FARAON ST STE 120
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-3512
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Country | US
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Telephone | 816-271-1066
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Fax | 816-271-6786
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2004001640
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 64349
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29302
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036116552
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-14709
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License Number State | AR
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | EMC0001234
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License Number State | MI
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