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Contact Information

SHANNON ACQUAVIVA
9733 HARVESTER CIR
PERRY HALL, MD21128-9027
 Phone: 443-415-3167
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SHANNON ACQUAVIVA · (Female)

NPI Number 1811403868
Status Active
Credentials
Entity Individual
Enumeration date 12/28/2017
Last updated 12/28/2017 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • MD License # R178155
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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