Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNA RACHELLE VIDOR, M.D.
ActiveSHANNA RACHELLE VIDOR, M.D. is a Family Medicine healthcare provider located in NETT LAKE, Minnesota. NPI 1215229729 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · NETT LAKE, MN
Registration Details
- NPI Number
- 1215229729
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 3, 2011 (15.315730541863 yrs)
- Last Updated
- Jun 18, 2020
- License
-
55689 (MN)
Practice Information
- Address
-
5219 ST JOHN DRIVENETT LAKE, MN, 557728232Browse MN providers · Browse ZIP 55772
- Phone
- 2187573295
- Primary Specialty
-
Family Medicine
207Q00000X
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.