Individual
SHANNON MINNEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, PMHNP-BC
Contact information
Practice address
5775 WAYZATA BLVD STE 875, ST LOUIS PARK, MN 55416-1235
(612) 306-1888
Mailing address
5775 WAYZATA BLVD STE 875, ST LOUIS PARK, MN 55416-1235
(612) 306-1888
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12257
MN
367500000X
Certified Registered Nurse Anesthetist
082484
MN
Other
Enumeration date
09/27/2009
Last updated
10/30/2024
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