Individual
SHELLY K. KEENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(866) 799-5886
Mailing address
PO BOX 1459, MINNEAPOLIS, MN 55440-1459
(866) 799-5886
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2011030536
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548542566
—
MO
05
—
200739410B
—
KS
Enumeration date
09/15/2011
Last updated
06/25/2020
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