SHANNON MARIE WALLACK

SAINT PAUL, MN
NPI1255578068
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MN  517)
Enumeration Date2009-01-15
Last Update Date2024-12-17
Business Address
Ms. SHANNON MARIE WALLACK CRNA
435 PHALEN BLVD
SAINT PAUL, MN 55130-5302
Phone number: 651-254-8080
Mailing Address
Ms. SHANNON MARIE WALLACK CRNA
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 55425-4516
Phone number: 952-883-5129
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