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Individual

MRS. SHANA M GLINIECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-4000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
146853-030
WI
367500000X
Certified Registered Nurse Anesthetist
075700
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA2135
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2886-033
APNP LICENSE
WI
05
44355600
WI
Enumeration date
07/09/2006
Last updated
11/17/2022
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