Provider Demographics
NPI:1639256738
Name:ROBINSON, SHANNON LIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:LIANE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1050 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2905
Mailing Address - Country:US
Mailing Address - Phone:573-364-2007
Mailing Address - Fax:573-202-2402
Practice Address - Street 1:1000 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2905
Practice Address - Country:US
Practice Address - Phone:573-364-9000
Practice Address - Fax:573-202-2484
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD115332084P0800X
WY12142C2084P0800X
NV188822084P0800X
IAMD-462622084P0800X
WI439-3202084P0800X
NE317522084P0800X
UT11287576-12052084P0800X
WAMD609570072084P0800X
IDMC-02112084P0800X
MS267222084P0800X
MN654452084P0800X
COCDR.00003472084P0800X
KS04392622084P0800X
CA860952084P0800X
MO20210027712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry