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General NPI Number Information
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NPI Number | 1932437142
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Entity Type | Individual
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Provider Name | SHANNON RENEE SEGRES YORKMAN
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Gender | Female
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Dates
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Enumeration Date | 11/28/2009
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 600 N WOLFE ST
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City | BALTIMORE
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State | MD
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Zip | 21287-4965
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Country | US
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Telephone | 410-955-1675
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Fax |
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Provider Business Mailing Address
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Address Line | 63 HORSEMAN CT
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4065
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Country | US
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Telephone | 443-392-7572
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R161384
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License Number State | MD
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