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General NPI Number Information
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NPI Number | 1619741196
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Entity Type | Individual
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Provider Name | SHANNON ANALLA MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 520 SW RAMSEY AVE
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City | GRANTS PASS
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State | OR
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Zip | 97527-5535
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Country | US
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Telephone | 541-472-7810
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Fax | 541-472-7811
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Provider Business Mailing Address
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Address Line | 2825 E BARNETT RD
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City | MEDFORD
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State | OR
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Zip | 97504-8332
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Country | US
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Telephone | 541-789-4207
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Fax | 541-789-4806
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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 | 10018651
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License Number State | OR
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