Individual
SHANNON SUZANNE SPIES INGERSOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, STE 250, COON RAPIDS, MN 55433-5850
(763) 398-0099
(763) 398-0124
Mailing address
14625 CTY RD 142 SE, DOVER, MN 55929
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209033784
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
R 134764-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120G5SP
BCBSMN
MN
05
—
203664900
—
MN
Enumeration date
08/12/2005
Last updated
03/13/2026
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