Individual
SHANNON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 PINE TREE DR, ARDEN HILLS, MN 55112-3754
(651) 635-8000
Mailing address
4401 ABBOTT AVE N, ROBBINSDALE, MN 55422-1416
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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