Individual
SUZANNE M. SHOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 676-5600
Mailing address
5039 ARCHER LN N, PLYMOUTH, MN 55446-2745
(612) 594-2425
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041379596
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041379596
ILLINOIS LICENSE
IL
Enumeration date
09/29/2009
Last updated
03/20/2020
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