Individual
SHAUNA MARISSA PANKRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8232 HIGHWAY 65 NE, SPRING LAKE PARK, MN 55432-2095
(763) 577-1877
(763) 577-1887
Mailing address
2355 126TH AVE NW, COON RAPIDS, MN 55448-2512
(651) 336-9254
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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