National Provider Identifier
Ian Shannon
Ian Shannon is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Rochester, NY and a listed phone number of (585) 275-2901.
Profile Overview
- NPI
- 1679461818
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- June 26, 2025
- Last Updated
- August 22, 2025
Practice Location
- 601 Elmwood Ave Fl 3
- Rochester, NY 14642-0001
Phone: (585) 275-2901
Mailing Address
- 601 Elmwood Ave
- Rochester, NY 14642-0001
Specialties
- Nurse Practitioner (363L00000X)
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1679461818
- Entity Type
- Individual
- Last Name
- Shannon
- First Name
- Ian
- Mailing Street Address
- 601 Elmwood Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 275-2100
- Practice Street Address
- 601 Elmwood Ave Fl 3
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 275-2901
- Enumeration Date
- June 26, 2025
- Last Updated
- August 22, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- August 22, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X), Registered Nurse (163W00000X)