SHANNON WILSON


Address: 228 19th St Sw, Rochester, MN 55902-2327
Phone: 5072613200

SHANNON WILSON (NPI# 1336617398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336617398
Entity Type Individual
Full Name SHANNON WILSON
Other Name SHANNON RUPORT
Credential RN
Practice Address 228 19th St Sw
Rochester
MN 55902-2327
Mailing Address 880 Golfview Ave
Zumbrota
MN 55992-7336
Practice Telephone 5072613200
Mailing Telephone 5072613200
Enumeration Date 2018-11-07
Last Update Date 2018-11-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WA2000X Registered Nurse
Specialization: Administrator
R100005 MN Nursing Service Providers

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Office Location

Street Address 228 19TH ST SW
City ROCHESTER
State MN
Zip Code 55902-2327

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487264446 Amber Nichelle Irby Dental Therapist 903 W Center St #130, Rochester, MN 55902 2020-08-05
1720584337 John E Herman Home and Treatment Facility, LLC Psychiatric Residential Treatment Facility 351 14th Ave Sw, Rochester, MN 55902 2018-04-03
1912442898 Esperanza Torres Dental Hygienist 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 2016-12-30
1578971149 Alduz Inri Surio Cabasa Student in an Organized Health Care Education/Training Program 609 1st Street Sw, Unit 102, Rochester, MN 55902 2014-07-28
1679901854 Julie Erickson Dental Hygienist United Way Building Suite #208, Rochester, MN 55902 2013-10-24
1619313590 Mercedes K Schulz Dental Hygienist 13394th Ave Sw, Rochester, MN 55902 2013-05-17
1093087389 Sarah Jean Dennison Clinic/Center 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 2012-02-01
1467732156 Angela Elizabeth Peters Registered Nurse 1450 2nd Avenue Sw, Rochester, MN 55902 2011-08-25
1528350071 Emily Zahasky Kraft Pharmacist 204 1st Street Sw, Rochester, MN 55902 2011-05-03
1093021982 Sherry Dawn Boutcher Dental Hygienist 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 2010-08-30
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Taxonomy Information

Taxonomy Code 163WA2000X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Administrator

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1043726342 Joseph Fleisher Registered Nurse 1111 Elmwood Ave, Rochester, NY 14620-3005 2017-12-21
1972951887 Susie Mae Gatewood Registered Nurse 281 W Ridge Rd, Rochester, NY 14615-2927 2016-06-01
1184094732 Eric John Jansen Registered Nurse 339 East Ave, Suite 303, Rochester, NY 14604-2627 2015-09-25
1104089028 Catherine J Brown Registered Nurse 100 Groton Pkwy, Rochester, NY 14623-4540 2008-07-10

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1093810244 Grattan Health Care Incorporated Registered Nurse 5710 County Road 121, Fort Ripley, MN 56449-1486 2006-09-13
1427044239 Janette Mary Setterquist Registered Nurse 927 Trettel Ln, Cloquet, MN 55720-1345 2005-09-27
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Competitor

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City ROCHESTER
Zip Code 55902

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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