Individual
SHAWN E WOLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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
8990 SPRINGBROOK DR NW, STE 250, COON RAPIDS, MN 55433-5850
(763) 398-0099
(763) 398-0124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
280028
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
R137597-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135416
—
AZ
01
—
281B6WO
BCBSMN
MN
05
—
988448000
—
MN
Enumeration date
09/14/2006
Last updated
03/27/2023
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