MEDICARE: SHANNON WRIGHT

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	71017886A	IN

General Provider Information

NPI Number	:	1831047174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON WRIGHT

Provider Business Mailing Address
First Line	:	3123 E 37TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1364
Country	:	US
Telephone Number	:	260-602-7374
Fax Number	:

Provider Business Practice Location Address
First Line	:	3123 E 37TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1364
Country	:	US
Telephone Number	:	260-602-7374
Fax Number	:

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “ SHANNON WRIGHT ” Practice Location

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