Most Relevant Information
Provider Data
| NPI Number: | 1003293762 |
| Provider Name: | SHANNON M WOOD FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 2015007598 |
Most Important Dates
| Enumeration Date: | 05/01/2015 |
| Last Updated: | 01/25/2016 |
Provider Practice Location
9209 PHOENIX VILLAGE PKWY
O FALLON
MO
633684280
Practice Location Phone/Fax
| Phone: | 6365614613 |
| Fax: | 6365614610 |
Provider Mailing Location
801 YORK ST
MANITOWOC
WI
542204630
Provider Mailing Phone/Fax
| Phone: | 9206639016 |
| Fax: | 9206841439 |