Provider Demographics
NPI:1194069633
Name:JAROT, SHANNON (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:JAROT
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:IL
Mailing Address - Zip Code:61360-9323
Mailing Address - Country:US
Mailing Address - Phone:815-357-8511
Mailing Address - Fax:815-357-1238
Practice Address - Street 1:271 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:IL
Practice Address - Zip Code:61360-9323
Practice Address - Country:US
Practice Address - Phone:815-357-8511
Practice Address - Fax:815-357-1238
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041275576163WL0100X
IL209.011554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant