Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON TABAKA, SW
Active Sole ProprietorSHANNON TABAKA, SW is a Lodging Provider healthcare provider located in ZIMMERMAN, Minnesota. NPI 1992680615 is currently active in the NPPES registry. Verify at CMS.
Lodging Provider · ZIMMERMAN, MN
Registration Details
- NPI Number
- 1992680615
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 11, 2025 (0.9697150706289 yrs)
- Last Updated
- Aug 11, 2025
- License
-
FBL4413164383 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12714 FREMONT AVEZIMMERMAN, MN, 553989406Browse MN providers · Browse ZIP 55398
- Phone
- 7637322065
- Primary Specialty
-
Lodging Provider
177F00000X
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.