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Individual

SHANDON HALLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, CNP

Contact information

Practice address
1439 PALACE AVE, SAINT PAUL, MN 55105-2556
(651) 230-8615
Mailing address
1439 PALACE AVE, SAINT PAUL, MN 55105-2556
(651) 230-8615

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2261823
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R 194672-3
MN

Other

Enumeration date
09/10/2009
Last updated
08/17/2010
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