Individual
SHANNON HOLLEY-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1902 10TH AVE, NEWPORT, MN 55055-1556
(612) 876-5895
Mailing address
1902 10TH AVE, NEWPORT, MN 55055-1556
(612) 876-5895
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
208311-9
MN
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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