# SHANNAN RAE DAHL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154082212
- **Gender:** F
- **Credential:** RN, MT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC0200X | Critical Care Medicine Registered Nurse | 0001298714 | VA | Yes |
| 225700000X | Massage Therapist | 0019011674 | VA | — |

## Other

- **Enumeration date:** 12/31/2021
- **Last updated:** 12/31/2021