SHANNON MARIE WALLACK

MINNEAPOLIS, MN
NPI1255578068
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MN  R1524268)
Enumeration Date2009-01-15
Last Update Date2014-07-18
Business Address
Ms. SHANNON MARIE WALLACK CRNA
2525 CHICAGO AVE
MINNEAPOLIS, MN 55404
Phone number: 612-813-6121
Mailing Address
Ms. SHANNON MARIE WALLACK CRNA
10747 FALLING WATER LN UNIT C
WOODBURY, MN 55129-5337
Phone number: 651-983-9756
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