Individual
SHANNA MIKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN RN-BC CPN CCRN
Contact information
Practice address
4655 YELLOWSTONE LN N, PLYMOUTH, MN 55446-3764
(314) 680-5592
Mailing address
4655 YELLOWSTONE LN N, PLYMOUTH, MN 55446-3764
(314) 680-5592
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
R2023506
MN
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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