Shaffer, Kristina Kelly

Shaffer, Kristina Kelly is an individual health care provider with primary practice located at 1215 Town Centre Dr Suite 200, Eagan MN 55123-1033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Shaffer, Kristina Kelly can be contacted via phone (651) 251-3300.

Contact Information

Primary practice address
1215 Town Centre Dr Suite 200 Eagan MN 55123-1033
Fax: (651) 255-3450
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 43145 Minnesota

Profile Details

NPI number 1730298910
LBN Legal business name Shaffer, Kristina Kelly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jan 28th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730298910 NPPES
Minnesota MEDICAID 190170200

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