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General NPI Number Information
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NPI Number | 1972101434
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Entity Type | Individual
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Provider Name | SHANNON MICHELLE BROWN RPH
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Gender | Female
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 350 US 31W BYP
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1770
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Country | US
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Telephone | 270-796-6067
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Fax | 270-496-4972
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Provider Business Mailing Address
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Address Line | 350 US 31W BYP
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1770
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Country | US
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Telephone | 270-796-6067
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Fax | 270-796-4972
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 010919
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License Number State | KY
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