Provider Demographics
NPI:1932245503
Name:KANNING, MARIANNE RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:RUTH
Last Name:KANNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-8925
Mailing Address - Country:US
Mailing Address - Phone:952-445-4722
Mailing Address - Fax:
Practice Address - Street 1:1446 COUNTY ROAD 14
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-8925
Practice Address - Country:US
Practice Address - Phone:952-445-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN21463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine