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NPI Code Detail

MEDICARE: SHANNON KATHLEEN LEVESQUE MSN, FNP-C

MEDICARE: SHANNON KATHLEEN LEVESQUE MSN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1174455042
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON KATHLEEN LEVESQUE MSN, FNP-C
Provider Business Mailing Address
First Line : 195 FAIRFIELD DR
Second Line :
City : NORTH KINGSTOWN
State : RI
Zip : 02852-1953
Country : US
Telephone Number : 508-846-0576
Fax Number :
Provider Business Practice Location Address
First Line : 2 MEEHAN LN
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1413
Country : US
Telephone Number : 401-658-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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