Most Relevant Information
Provider Data
| NPI Number: | 1003669870 |
| Provider Name: | SHANNA MICHELE WIRTZ AG-ACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2024 |
| Last Updated: | 04/10/2024 |
Provider Practice Location
1044 BELMONT AVE
YOUNGSTOWN
OH
445041006
Practice Location Phone/Fax
| Phone: | 0000000000 |
| Fax: |
Provider Mailing Location
4320 NEW CASTLE RD
LOWELLVILLE
OH
444368721
Provider Mailing Phone/Fax
| Phone: | 3305069737 |
| Fax: |