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NPI Code Detail

MEDICARE: SHANNON MCKINNIS

MEDICARE:   SHANNON  MCKINNIS
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
13747P1801XPersonal Care Attendant
2374U00000XHome Health Aide

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2401754440515OTHEROHSTNA

General Provider Information

NPI Number : 1275999815
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MCKINNIS
Provider Business Mailing Address
First Line : 1219 LANGLAND DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2648
Country : US
Telephone Number : 614-348-9262
Fax Number : 614-457-3636
Provider Business Practice Location Address
First Line : 1219 LANGLAND DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2648
Country : US
Telephone Number : 614-348-9262
Fax Number : 614-457-3636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2016
Last Update Date : 12/21/2025

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Directions to “ SHANNON MCKINNIS ” Practice Location

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