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Individual

SHANE R FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
10077 DOGWOOD ST. NW, SUITE 110, MINNEAPOLIS, MN 55448
(763) 792-9471
(763) 792-9472
Mailing address
10077 DOGWOOD ST. NW, SUITE 110, MINNEAPOLIS, MN 55448
(763) 792-9471
(763) 792-9472

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 224658-7
MN

Other

Enumeration date
02/06/2015
Last updated
02/06/2015
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