Provider Demographics
NPI:1932663945
Name:CARPANI, SHANNON CHRISTINE (BSN, RN, NC-BC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:CHRISTINE
Last Name:CARPANI
Suffix:
Gender:F
Credentials:BSN, RN, NC-BC
Other - Prefix:MISS
Other - First Name:SHANNON
Other - Middle Name:CHRISTINE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:24887 STRIKE ST
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9792
Mailing Address - Country:US
Mailing Address - Phone:541-337-5278
Mailing Address - Fax:
Practice Address - Street 1:24887 STRIKE ST
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9792
Practice Address - Country:US
Practice Address - Phone:541-337-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201042806RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse