Individual
SHANNON LEE HOVERSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-3200
Mailing address
1678 CHATEAU AVE, SHAKOPEE, MN 55379-3389
(952) 997-7754
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07151393
MN
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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