Provider Demographics
NPI:1497917611
Name:BEEBE, SHANNON ANN (BS)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ANN
Last Name:BEEBE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 COUNTY ROUTE 6
Mailing Address - Street 2:APT. B
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4023
Mailing Address - Country:US
Mailing Address - Phone:315-598-7625
Mailing Address - Fax:
Practice Address - Street 1:1728 COUNTY ROUTE 6
Practice Address - Street 2:APT. B
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4023
Practice Address - Country:US
Practice Address - Phone:315-598-7625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator