Provider Demographics
NPI:1194943639
Name:ROBISON, SHANNON MARIE (RPH)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:ROBISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 HAYDEN DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1178
Mailing Address - Country:US
Mailing Address - Phone:406-652-2514
Mailing Address - Fax:
Practice Address - Street 1:3155 AVENUE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-8109
Practice Address - Country:US
Practice Address - Phone:406-657-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist