SHANNON KUETTEL (NPI# 1124544051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124544051 |
Entity Type | Individual |
Full Name | SHANNON KUETTEL |
Other Name | SHANNON OLSON |
Credential | PA-C |
Practice Address |
6320 W Union Hills Dr Ste A180 Glendale AZ 85308-7153 |
Mailing Address |
4700 N 16th St Apt 235 Phoenix AZ 85016-4662 |
Practice Telephone | 6237488300 |
Practice Fax Number | 6237488314 |
Mailing Telephone | 6123252022 |
Enumeration Date | 2017-08-22 |
Last Update Date | 2017-08-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
6320 W UNION HILLS DR STE A180 |
City | GLENDALE |
State | AZ |
Zip Code | 85308-7153 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508022070 | Christine Harter Md PC | Pain Medicine | 6320 W Union Hills Dr Ste A180, Glendale, AZ 85308 | 2008-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
Find all providers in zip 85308 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
1417519588 | Elizabeth Lisa Chilian | Physician Assistant | 345 Pioneer Dr Unit 1203, Glendale, CA 91203-2780 | 2019-06-28 |
1659846988 | Gabriel Thomas Lopez | Physician Assistant | 7419 W Planada Ln, Glendale, AZ 85310-5886 | 2018-10-13 |
1417445487 | Core Geriatric Medical Group LLC | Physician Assistant | 1505 S Glendale Ave, Glendale, CA 91205-3315 | 2018-04-25 |
1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
1114465598 | Diana Andreea Stan | Physician Assistant | 18555 N 79th Ave Ste B108, Glendale, AZ 85308 | 2017-02-07 |
1235687310 | Lynzi Kay Warner | Physician Assistant | 4344 W Bell Rd Ste 102, Glendale, AZ 85308-3589 | 2016-09-16 |
1558737791 | Martin Airian | Physician Assistant | 1577 E Chevy Chase Dr Ste 240, Glendale, CA 91206-4742 | 2015-08-11 |
Find all providers in GLENDALE |
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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.