Provider Demographics
NPI:1770720575
Name:REILLY, SHANNON LEIGH (CNM)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:LEIGH
Last Name:REILLY
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:159 BAYARD STREET
Mailing Address - Street 2:
Mailing Address - City:PORT EWEN
Mailing Address - State:NY
Mailing Address - Zip Code:12466-0313
Mailing Address - Country:US
Mailing Address - Phone:845-399-3620
Mailing Address - Fax:
Practice Address - Street 1:1201 LANGHORNE NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1201
Practice Address - Country:US
Practice Address - Phone:215-710-2000
Practice Address - Fax:215-710-4633
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2021-05-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife