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Individual

SHANNON WHALEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
895 7TH ST E, SAINT PAUL, MN 55106-3871
(651) 602-7500
(651) 222-1305
Mailing address
895 7TH ST E, SAINT PAUL, MN 55106-3871
(651) 602-7500
(651) 222-1305

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
655
MN
364S00000X
Clinical Nurse Specialist
R1740327
MN

Other

Enumeration date
07/23/2013
Last updated
03/01/2023
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