SHANNON MARIE MOONEY (NPI# 1508397290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508397290 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE MOONEY |
| Credential | CNP |
| Practice Address |
45 10th St W Saint Paul MN 55102-1062 |
| Mailing Address |
396 Linda Ave Lino Lakes MN 55014-6404 |
| Practice Telephone | 6513263800 |
| Mailing Telephone | 6127704296 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2019-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
CNP 5045 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3433 Broadway St Ne Ste 300, Minneapolis, MN 554131761 | 7635877737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295388080 | Shannon Mooney | Clinic/Center | 376 5th St, Idaho Falls, ID 83401-4762 | 2019-07-20 |
| 1487809083 | Shannon M Mooney | Physician Assistant | 13 Loder St, Wellsville, NY 14895 | 2008-11-24 |
| 1154890796 | Shannon Quinn Mooney | Counselor | 8 Lowell Rd, West Hartford, CT 06119-1817 | 2018-11-13 |
| 1457428609 | Shannon Leigh Mooney | Pediatrics | 1001 Little Oak Way, Round Rock, TX 78681-5516 | 2006-11-30 |
| 1356423024 | Shannon Margaret Mooney | Dietitian, Registered | 295 Varnum Ave, Suite 204, Lowell, MA 01854-2134 | 2006-10-20 |
| Street Address |
45 10TH ST W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205471 | Christina L Lester | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2005-06-21 |
| 1669073029 | Babatunde Safiriyu Adams | Clinical Nurse Specialist | 45 10th St W, Saint Paul, MN 55102-1062 | 2020-11-03 |
| 1427657139 | Michael Omomo | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2020-10-22 |
| 1386273944 | Jayson Robinson | Respiratory Therapist, Registered | 45 10th St W, Saint Paul, MN 55102-1062 | 2020-04-06 |
| 1508490558 | Maureen Valerie Foster | Counselor | 45 10th St W, Saint Paul, MN 55102-1053 | 2020-02-28 |
| 1518599950 | Danielle Davenport | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1053 | 2020-02-04 |
| 1871133694 | Esther Gillispie | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2020-01-09 |
| 1427694926 | Katherine Marie Betzel | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2019-11-20 |
| 1992340194 | Marit Leigh Throntveit | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2019-11-12 |
| 1932742400 | Christina Froehling | Nurse Practitioner | 45 10th St W, Saint Paul, MN 55102-1062 | 2019-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538573449 | Rebecca Anne Lenz | Nurse Practitioner | 1172 Randolph Ave Apt 8, Saint Paul, MN 55105-2987 | 2014-06-18 |
| 1720016660 | Sasenarine Singh | Nurse Practitioner | 1690 University Ave W Ste 115, Saint Paul, MN 55104-3118 | 2006-06-29 |
| 1528043171 | Kathryn I Kreslins | Nurse Practitioner | 1055 Westgate Dr, Suite 100, Saint Paul, MN 55114-1065 | 2005-12-07 |
| 1316347313 | Amanda Jean Lueck | Nurse Practitioner | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2014-08-27 |
| 1700215001 | Jenifer Wynne | Nurse Practitioner | 1055 Westgate Dr, Saint Paul, MN 55114-1065 | 2013-11-06 |
| 1215365606 | Maria Tarlue Keita | Nurse Practitioner | 1055 Westgate Dr, Suite 100, Saint Paul, MN 55114-1065 | 2013-10-22 |
| 1164702742 | Kelli A Petersen | Nurse Practitioner | 1055 Westgate Dr, Saint Paul, MN 55114-1065 | 2011-08-26 |
| 1750684049 | Lisa Marie Terhaar | Nurse Practitioner | 1055 Westgate Dr, Suite 100, Saint Paul, MN 55114-1065 | 2010-12-08 |
| 1649438417 | Momodou Ceesay | Nurse Practitioner | 1021 Bandana Blvd E, Suite 214, Saint Paul, MN 55108-5113 | 2008-05-29 |
| 1013067610 | Kathleen Annette Keogh | Nurse Practitioner | 1055 Westgate Dr, Saint Paul, MN 55114-1065 | 2007-01-12 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55102 |
Please comment or provide details below to improve the information on SHANNON MARIE MOONEY.
| 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.