Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Shannon Marie Jennings, AGACNP-BC

Individual provider Registered Nurse · NPI 1396493789

MS. Shannon Marie Jennings, AGACNP-BC is a Nurse Practitioner in Mesa, Arizona. Qualified in 2022, 4 years ago. Practices with Banner Physician Specialists Arizona LLC, a 372-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2024 S Baldwin Unit 76
Mesa, AZ 85209-1706
Phone: (504) 909-3872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 276686 (AZ)
Registered Nurse Taxonomy 163W00000X · Licence RN205721 (AZ)

Record details

NPI number1396493789
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedMarch 14, 2022
Last updated in NPPESFebruary 10, 2024
Certification dateFebruary 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Banner Physician Specialists Arizona Llc — 372 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Mesa