Individual
MR. SHAWN THOMAS GAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1544 SHELDON ST, SAINT PAUL, MN 55108-2331
(651) 646-3091
(651) 646-3124
Mailing address
1544 SHELDON ST, SAINT PAUL, MN 55108-2331
(651) 646-3091
(651) 646-3124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
R 139202-1
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
RN223809
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
985190900
—
MN
Enumeration date
03/15/2006
Last updated
06/14/2022
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