1588359210 NPI number — DR. SHANNON LEIGH DUMMER DNP, FNP, CEN

Table of content: DR. SHANNON LEIGH DUMMER DNP, FNP, CEN (NPI 1588359210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588359210 NPI number — DR. SHANNON LEIGH DUMMER DNP, FNP, CEN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUMMER
Provider First Name:
SHANNON
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP, CEN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'CONNOR
Provider Other First Name:
SHANNON
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588359210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1352 WALNUT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21403-4748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-221-8716
Provider Business Mailing Address Fax Number:
949-437-8515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1352 WALNUT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21403-4748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-221-8716
Provider Business Practice Location Address Fax Number:
949-437-8515
Provider Enumeration Date:
04/10/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R246089 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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