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Individual

MS. JESSICA SHAPPELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7435 OAKLEY ST NE, FRIDLEY, MN 55432-3431
(651) 508-8695
Mailing address
7435 OAKLEY ST NE, FRIDLEY, MN 55432-3431
(651) 508-8695

Taxonomy

Speciality
Code
Description
License number
State
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
99002353
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LMN726133520
MN
Enumeration date
04/13/2021
Last updated
04/13/2021
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