Shannon N Siekas
Nurse Practitioner - Family Medicine
13060 Isle Dr
Baxter
, Minnesota 56425-8331
Shannon N Siekas
Nurse Practitioner - Family Medicine
13060 Isle Dr
Baxter
, Minnesota 56425-8331
(218) 454-5916
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Shannon N Siekas
- 523 N 3rd St
- Brainerd, MN
- Zip : 56401-3054
- Fax : (218) 454-5916
- Phone : (218) 828-2880
Second Address
- Shannon N Siekas
- 13060 Isle Dr
- Baxter, MN
- Zip : 56425-8331
- Phone : (218) 828-2880
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 179217-1 | MN |
National Provider Identifier
| NPI | 1003222597 |
|---|---|
| Provider Name | Shannon N Siekas |
| First Address | Brainerd, MN 56401-3054 |
| Second Address | Baxter, MN 56425-8331 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/07/2014 |
| Last Update Date | 15/01/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1792171 | MN BOARD OF NURSING (01) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.