Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. SHANNON CARL NELSON, OTR
Active Sole ProprietorMR. SHANNON CARL NELSON, OTR is a General Acute Care Hospital healthcare provider located in RED LAKE, Minnesota. NPI 1104029388 is currently active in the NPPES registry. Verify at CMS.
General Acute Care Hospital · RED LAKE, MN
Registration Details
- NPI Number
- 1104029388
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 6, 2007 (19.182882919407 yrs)
- Last Updated
- Jul 8, 2007
- License
-
102239 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
HIGHWAY 1 BOX 497RED LAKE, MN, 56671Browse MN providers · Browse ZIP 56671
- Phone
- 2186793316
- Primary Specialty
-
General Acute Care Hospital
282N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.