Provider Demographics
NPI:1265008866
Name:GINN, SHANNA LYNN
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:LYNN
Last Name:GINN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHANNA
Other - Middle Name:LYNN
Other - Last Name:LAHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6998 N US HIGHWAY 27 STE 104
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-3998
Mailing Address - Country:US
Mailing Address - Phone:352-351-3784
Mailing Address - Fax:
Practice Address - Street 1:6998 N US HIGHWAY 27 STE 104
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-3998
Practice Address - Country:US
Practice Address - Phone:352-351-3784
Practice Address - Fax:352-351-1060
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist