National Provider Identifier
Shannon Lee Blaisdell, RN
Shannon Lee Blaisdell, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Lakewood, NY and a listed phone number of (315) 283-6032.
Profile Overview
- NPI
- 1356888481
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- January 26, 2017
- Last Updated
- May 18, 2022
Practice Location
- 4440 Chautauqua Blvd
- Lakewood, NY 14750-9718
Phone: (315) 283-6032
Specialties
- Registered Nurse (163W00000X)
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1356888481
- Entity Type
- Individual
- Last Name
- Blaisdell
- First Name
- Shannon
- Middle Name
- Lee
- Credential
- RN
- Mailing Street Address
- 4440 Chautauqua Blvd
- Mailing City
- Lakewood
- Mailing State
- NY
- Mailing ZIP Code
- 14750-9718
- Mailing Country
- US
- Mailing Phone
- (315) 283-6032
- Practice Street Address
- 4440 Chautauqua Blvd
- Practice City
- Lakewood
- Practice State
- NY
- Practice ZIP Code
- 14750-9718
- Practice Country
- US
- Practice Phone
- (315) 283-6032
- Enumeration Date
- January 26, 2017
- Last Updated
- May 18, 2022
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- May 18, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X), Licensed Practical Nurse (164W00000X)
- Other Identifiers
- 326785 (NY)