Provider Demographics
NPI:1649886219
Name:ADDINGTON, SHANNON BRITTANY
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:BRITTANY
Last Name:ADDINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8855 E MADERA DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85650-9014
Mailing Address - Country:US
Mailing Address - Phone:520-255-6283
Mailing Address - Fax:
Practice Address - Street 1:901 E VAN BUREN ST APT 2021
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-4030
Practice Address - Country:US
Practice Address - Phone:520-255-6283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer