Provider Demographics
NPI:1891979449
Name:BAY, SHANNON ERIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:ERIN
Last Name:BAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9582 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9778
Mailing Address - Country:US
Mailing Address - Phone:513-346-5640
Mailing Address - Fax:513-346-5644
Practice Address - Street 1:9582 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-9778
Practice Address - Country:US
Practice Address - Phone:513-346-5640
Practice Address - Fax:513-346-5644
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH1834363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant