Individual
MS. MARCIA ANN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP C
Contact information
Practice address
40520 COUNTY HIGHWAY 34, OGEMA, MN 56569-9612
(218) 983-4300
(218) 983-6360
Mailing address
40520 COUNTY HIGHWAY 34, OGEMA, MN 56569-9612
(218) 983-4300
(218) 983-6360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN24590
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8HL323
MEDICARE PTAN
MN
Enumeration date
02/22/2006
Last updated
06/06/2012
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