Provider Demographics
NPI:1083928410
Name:BIERGANS, SHANNON MARIE (MS, MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MARIE
Last Name:BIERGANS
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Gender:F
Credentials:MS, MSN, RN, FNP-BC
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Mailing Address - Street 1:1035 CHARLEVOIX DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-2223
Mailing Address - Country:US
Mailing Address - Phone:517-627-2181
Mailing Address - Fax:517-622-1242
Practice Address - Street 1:1035 CHARLEVOIX DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2223
Practice Address - Country:US
Practice Address - Phone:517-627-2181
Practice Address - Fax:517-622-1242
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2013-12-16
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Provider Licenses
StateLicense IDTaxonomies
MI4704226067163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse