Provider Demographics
NPI:1952537003
Name:COLES, SHANNON KATHERINE (BS,RRT, AE-C)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:KATHERINE
Last Name:COLES
Suffix:
Gender:F
Credentials:BS,RRT, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 APACHE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4690
Mailing Address - Country:US
Mailing Address - Phone:301-668-7271
Mailing Address - Fax:
Practice Address - Street 1:812 APACHE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4690
Practice Address - Country:US
Practice Address - Phone:301-668-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL024312279E1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEducational