Shanna Miko, MSN RN-BC CPN CCRN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

R2023506 Issued in MN

Practice address

4655 Yellowstone LN N
Plymouth, MN 55446-3764

Phone

(314) 680-5592

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1194289389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 YELLOWSTONE LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463764",
            "telephone_number": "314-680-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 YELLOWSTONE LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463764",
            "telephone_number": "314-680-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKO",
        "first_name": "SHANNA",
        "credential": "MSN RN-BC CPN CCRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MN",
            "license": "R2023506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Louis Michelich, D.D.S.
• Crystal Micoley, DC
• Midwest Immunology Clinics, PLLC
• Midwest Physical Therapy LLC
• Layton Mikkalson, DDS
• Joanna Marie Miles
• Mary Z Miley
• Millennium Home Care
• Ahna Xiaofan Miller
• Brian Richard Miller, MD

• Pediatric Registered Nurse in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Pediatric Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.