SHANNON BRENT (NPI# 1093249153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093249153 |
| Entity Type | Individual |
| Full Name | SHANNON BRENT |
| Practice Address |
11706 Clifton Blvd Lakewood OH 44107-2018 |
| Mailing Address |
12925 Clifton Blvd Lakewood OH 44107-1527 |
| Practice Telephone | 6142262131 |
| Enumeration Date | 2017-04-16 |
| Last Update Date | 2017-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN.340899 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881817807 | Shannon Brent | Social Worker | 101 N Zang Blvd, Dallas, TX 75208-4528 | 2007-04-10 |
| Street Address |
11706 CLIFTON BLVD |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811483092 | Kelly Effner | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107 | 2018-07-10 |
| 1356832968 | Lorrie Miller | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107 | 2018-05-21 |
| 1356831879 | Tina Marie Hrenko | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107-2018 | 2018-05-10 |
| 1497242051 | Killian Leitner | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107-2018 | 2018-04-19 |
| 1033570346 | Nicole Buckley | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107-2018 | 2016-03-14 |
| 1346682309 | Erin Satullo | Registered Nurse | 11706 Clifton Blvd, Lakewood, OH 44107-2018 | 2013-07-19 |
| 1467766261 | Courtney Brooke Gravens | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107 | 2010-08-04 |
| 1053599027 | Maureen Owens | Nurse Practitioner | 11706 Clifton Blvd, Lakewood, OH 44107-2018 | 2008-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218574 | Primary Health Services LLC | Nurse Practitioner | 500 River Ave Ste 200, Lakewood, NJ 08701-4719 | 2020-09-01 |
| 1235748237 | Esther Steinhaus | Nurse Practitioner | 409 Ashley Ave, Lakewood, NJ 08701-4866 | 2020-07-26 |
| 1609402817 | Bridgit V Wedgle | Nurse Practitioner | 2556 S Jellison Ct, Lakewood, CO 80227-2872 | 2020-03-19 |
| 1255963187 | Tresa Marie Glaser | Nurse Practitioner | 8807 25th Ave S, Lakewood, WA 98499-8301 | 2020-02-08 |
| 1972149490 | Richard Allan Coronel Sy | Nurse Practitioner | 11645 Walcroft St, Lakewood, CA 90715-1356 | 2019-11-19 |
| 1609411867 | Jennifer Lynn Wondel | Nurse Practitioner | 10424 W Arkansas Dr, Lakewood, CO 80232-5014 | 2019-11-12 |
| 1457901555 | Nancy Wairimu Minjire | Nurse Practitioner | 9537 Gravelly Lake Dr Sw # E10, Lakewood, WA 98499-1513 | 2019-09-19 |
| 1619432325 | Soroh Neuberger | Nurse Practitioner | 232 Jamescrest Ct, Lakewood, NJ 08701-4708 | 2019-02-06 |
| 1487118782 | Krista Leigh Petry | Nurse Practitioner | 4720 Baker St, Lakewood, NY 14750-9772 | 2019-01-31 |
| 1649740093 | Svetlana Polyakova | Nurse Practitioner | 8316 W Eastman Pl, Lakewood, CO 80227-6240 | 2018-11-28 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.