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General NPI Number Information
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NPI Number | 1972053627
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Entity Type | Individual
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Provider Name | SHANNON BURKHART FNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 100 KETTERING WAY STE 100
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City | FRANKLIN
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State | OH
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Zip | 45005-1155
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Country | US
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Telephone | 937-746-8357
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Fax |
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Provider Business Mailing Address
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Address Line | 909 E 2ND ST
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City | FRANKLIN
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State | OH
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Zip | 45005-1700
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Country | US
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Telephone | 937-746-8357
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Fax | 937-746-1992
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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 | APRN.CNP.019907
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License Number State | OH
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