Individual
SHANNON OBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
856 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4807
(651) 665-9795
Mailing address
856 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4807
(651) 665-9795
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
76336-3
MN
Other
Enumeration date
07/30/2015
Last updated
11/01/2015
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