NPI 1386033702 · live from the CMS NPI Registry
Shannon Aifuwa, Nurse Practitioner
Nurse Practitioner, Adult Health in Glen Allen, VA. National Provider Identifier 1386033702, active.
NPI record
| NPI | 1386033702 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Adult Health 363LA2200X |
| Practice location | 11331 W Broad St, 129, Glen Allen, VA 23060 |
| Practice phone | 804-364-0521 |
| Enumerated | January 22, 2015 |
| Last updated | January 22, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Adult Health primary | 363LA2200X | 0024171617 (VA) |
| Nurse Practitioner, Gerontology | 363LG0600X | 0024171617 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.