Shaw, Debra Lynn
Shaw, Debra Lynn is an sole proprietor health care provider with primary practice located at 3400 West 66Th Street Suite 290, Edina MN 55435. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Shaw, Debra Lynn can be contacted via phone (952) 914-1882.Contact Information
Primary practice address
3400 West 66Th Street Suite 290
Edina MN 55435
Phone: (952) 914-1882
Fax: (952) 914-1727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R144120-2 | Minnesota |
Profile Details
| NPI number | 1154494029 |
|---|---|
| LBN Legal business name | Shaw, Debra Lynn |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Mar 11th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154494029 | NPPES |
| Minnesota | MEDICAID | 6409270-00 | |
| Minnesota | Other | 500004309 |
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