Individual
MRS. SHANNON CHRISTIAN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
13060 ISLE DR, BAXTER, MN 56425-8331
(512) 981-8445
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2134165
MN
Other
Enumeration date
08/03/2015
Last updated
01/15/2016
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