Shannon Marie Hacka

NPI #1003438037 in Saint Paul, Minnesota

Provider Information

NPI Number: 1003438037
Entity Type: Individual
Name: Shannon Marie Hacka
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 13, 2020
Last Updated: May 13, 2020

Practice Location

Address: 1011 MEADOWLANDS DR STE 1&2
City: Saint Paul
State: Minnesota
ZIP Code: 55127-2339
Phone: (507) 322-7752

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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