NPI 1659409563 · live from the CMS NPI Registry
Shannon M Beasley, CPNP, PHN, CDE
Nurse Practitioner, Pediatrics in Minneapolis, MN. National Provider Identifier 1659409563, active.
NPI record
| NPI | 1659409563 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 516 Delaware St. Se, Pwb Room 7-111, Mmc 504, Minneapolis, MN 55455 |
| Practice phone | 612-626-5609 |
| Enumerated | March 1, 2007 |
| Last updated | December 4, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 3938 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.