Basic Information
| Provider Information | |||||||||
| NPI: | 1023263712 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHNELL | ||||||||
| FirstName: | SHANNON | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 117 TRADEPARK DR | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425033428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066792773 | ||||||||
| FaxNumber: | 6066794626 | ||||||||
| Practice Location | |||||||||
| Address1: | 117 TRADEPARK DR | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425033428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066792773 | ||||||||
| FaxNumber: | 6066794626 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2008 | ||||||||
| LastUpdateDate: | 07/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 00376 | KY | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.