MEDICARE: SHANNON SMITH NP

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
1	363LF0000X	Family Nurse Practitioner	R198429	MD
2	363LF0000X	Family Nurse Practitioner	LG-0011482	DE
3	363L00000X	Nurse Practitioner	LG-0011482	DE
4	363L00000X	Nurse Practitioner	R198429	MD

General Provider Information

NPI Number	:	1588998207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON SMITH NP

Provider Business Mailing Address
First Line	:	PO BOX 1613
Second Line	:
City	:	BERLIN
State	:	MD
Zip	:	21811-5613
Country	:	US
Telephone Number	:	443-513-0821
Fax Number	:	443-513-3679

Provider Business Practice Location Address
First Line	:	1400 COASTAL HWY
Second Line	:
City	:	FENWICK ISLAND
State	:	DE
Zip	:	19944-4452
Country	:	US
Telephone Number	:	443-373-3245
Fax Number	:	443-513-3679

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	01/05/2026

Similar Medicare Providers

1225004294 — DR. NICHOLAS NICHOLSON BORODULIA M.D.
Practice Location Address:

1400 COASTAL HWY
FENWICK ISLAND, DE
19944-4452

Practice Phone: 302-581-0458
Practice Fax: 302-581-0460

1396780664 — FENWICK MEDICAL CENTER PA
Practice Location Address:

1400 COASTAL HWY
FENWICK ISLAND, DE
19944

Practice Phone: 302-581-0458
Practice Fax: 302-581-0460

1871772301 — DR. RONALD RAY BLANCK D.O.
Practice Location Address:

1613 BAY ST
FENWICK ISLAND, DE
19944-4506

Practice Phone: 302-541-4137
Practice Fax: 302-541-4137

1194181727 — MRS. MARY H STRONG
Practice Location Address:

38968 WILLOW LN
FENWICK ISLAND, DE
19944-4040

Practice Phone: 585-451-0283
Practice Fax:

1124575709 — MRS. NING WANG ACUPUNCTURIST
Practice Location Address:

9001 SE 47TH ST
MERCER ISLAND, WA
98040-4452

Practice Phone: 206-519-9006
Practice Fax:

1740761626 — NADINE DENIS
Practice Location Address:

1000 TARGEE ST
STATEN ISLAND, NY
10304-4452

Practice Phone: 347-993-6018
Practice Fax:

Directions to “ SHANNON SMITH NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.