Provider Demographics
NPI:1083336333
Name:NARDO, SHANNON MAUREEN
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MAUREEN
Last Name:NARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4720
Mailing Address - Country:US
Mailing Address - Phone:302-992-5558
Mailing Address - Fax:
Practice Address - Street 1:2101 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4720
Practice Address - Country:US
Practice Address - Phone:302-992-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0033113163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool