Individual
SHANNON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
228 19TH ST SW, ROCHESTER, MN 55902-2327
(507) 261-3200
Mailing address
880 GOLFVIEW AVE, ZUMBROTA, MN 55992-7336
(507) 261-3200
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
R100005
MN
Other
Enumeration date
11/07/2018
Last updated
11/17/2018
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