Provider Demographics
NPI:1659062024
Name:BISBEE, SHANNON MARIE (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHANNON
Middle Name:MARIE
Last Name:BISBEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LEE RD
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-4842
Mailing Address - Country:US
Mailing Address - Phone:440-319-0627
Mailing Address - Fax:
Practice Address - Street 1:9220 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6412
Practice Address - Country:US
Practice Address - Phone:440-639-3563
Practice Address - Fax:833-301-0856
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.522132163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health