Provider Demographics
NPI:1598113243
Name:LAMBERT, SHANNON (PA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20970
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7020
Mailing Address - Country:US
Mailing Address - Phone:307-996-1560
Mailing Address - Fax:
Practice Address - Street 1:800 E 20TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3859
Practice Address - Country:US
Practice Address - Phone:307-996-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant