Provider Demographics
NPI:1083853675
Name:RHOTON, SHANNON KAY (MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:KAY
Last Name:RHOTON
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:KAY
Other - Last Name:WHITING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1919 LATHROP ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5930
Mailing Address - Country:US
Mailing Address - Phone:907-456-8191
Mailing Address - Fax:907-456-8192
Practice Address - Street 1:1919 LATHROP ST
Practice Address - Street 2:SUITE 217
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5930
Practice Address - Country:US
Practice Address - Phone:907-456-8191
Practice Address - Fax:907-456-8192
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1072363LF0000X
MO2004031239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily