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NPI Code Detail

MEDICARE: SHANNON BAREND LPN

MEDICARE:   SHANNON  BAREND  LPN
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
1164W00000XLicensed Practical Nurse290042NY

General Provider Information

NPI Number : 1548916182
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON BAREND LPN
Provider Business Mailing Address
First Line : 1010 MAIDEN LN
Second Line :
City : ROCHESTER
State : NY
Zip : 14615-1126
Country : US
Telephone Number : 585-750-0396
Fax Number :
Provider Business Practice Location Address
First Line : 1010 MAIDEN LN
Second Line :
City : ROCHESTER
State : NY
Zip : 14615-1126
Country : US
Telephone Number : 585-750-0396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2022
Last Update Date : 02/22/2022

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