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Shannon Acquaviva
Family Nurse Practitioner in Perry Hall, Maryland
NPI 1811403868

Shannon Acquaviva is a Family Nurse Practitioner based in Perry Hall, MD and is specialized in Family. Shannon Acquaviva practices in Perry Hall, MD. The NPI Number for Shannon Acquaviva is 1811403868 and holds a License No. R178155 (Maryland).

The current practice location address for Shannon Acquaviva is 9733 Harvester Cir, Perry Hall, MD and can be reached out via phone at 443-415-3167.

Location: 9733 Harvester Cir, Perry Hall, MD, 21128-9027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811403868
Provider Name
Shannon Acquaviva
Credential
Provider Entity Type
Individual
Gender
Female
Address
9733 Harvester Cir, Perry Hall, MD, 21128-9027
Phone Number
443-415-3167
Fax Number
Provider Enumeration Date
12/28/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9733 Harvester Cir
City
Perry Hall
State
Maryland
Zip
21128-9027
Phone Number
443-415-3167
Fax Number
person
Provider Business Mailing Address Details
Address
9733 Harvester Cir
City
Perry Hall
State
Maryland
Zip
21128-9027
Phone Number
443-415-3167
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
R178155 (Maryland)
Definition
Definition to come...
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