Shields, Mary

Shields, Mary is an individual health care provider with primary practice located at 3366 Oakdale Ave N Suite 551, Robbinsdale MN 55422-2948. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Shields, Mary can be contacted via phone (763) 587-7737.

Contact Information

Primary practice address
3366 Oakdale Ave N Suite 551 Robbinsdale MN 55422-2948
Phone: (763) 587-7737
Fax: (763) 587-7069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R0790556 Minnesota

Profile Details

NPI number 1033139910
LBN Legal business name Shields, Mary
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Oct 25th, 2013 - about 12 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 1033139910 NPPES
Minnesota MEDICAID 698517300

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