Provider Demographics
NPI:1295534964
Name:METZGER, SHANNON ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ELIZABETH
Last Name:METZGER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3776 OLD SALEM RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1428
Mailing Address - Country:US
Mailing Address - Phone:937-307-5796
Mailing Address - Fax:
Practice Address - Street 1:3776 OLD SALEM RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1428
Practice Address - Country:US
Practice Address - Phone:937-307-5796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker