| Doctor Name: | SHANNON SLAGTER |
| NPI Number: | 1972853208 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | R1789773 |
| Business Practice Address: | 1100 E Broadway St Redwood Falls, MN - 562832247 |
| Business Phone Number: | 5076372985 |
| Business Fax Number: | 5076373057 |
| Mailing Address: | 1100 E Broadway St, REDWOOD FALLS |
| State: | MN |
| Postal Code: | 562832247 |
| Phone Number: | 5076372985 |
| Fax Number: | 5076373057 |
| NPI Enumeration Date: | 09/13/2012 |
| NPI Last Update Date: | 09/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | R1789773 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |