Provider Demographics
NPI:1093777674
Name:SHANNON, ERIN KATE (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KATE
Last Name:SHANNON
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:3240 MONROE AVE
Mailing Address - Street 2:IDEAL IMAGE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:813-286-8100
Mailing Address - Fax:888-860-5225
Practice Address - Street 1:3240 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-256-3550
Practice Address - Fax:585-256-3554
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant