Individual
KIM A MALETTA SHIBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
560 S MAPLE ST STE 130, WACONIA, MN 55387-1753
(952) 442-2191
Mailing address
560 S MAPLE ST STE 130, WACONIA, MN 55387-1753
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37029
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309325500
—
MN
Enumeration date
03/30/2006
Last updated
09/15/2022
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