Individual
SHANNON MARGARET BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2550 UNIVERSITY AVE W STE 143N, SAINT PAUL, MN 55114-1098
(651) 642-1013
Mailing address
3600 HAMILTON AVE, WAYZATA, MN 55391-3129
(612) 210-8621
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10552
MN
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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