Individual
SHAKETHA CRUTCHFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 MINNEHAHA AVE, STE 130 #11, MINNEAPOLIS, MN 55406
(612) 505-2602
Mailing address
2740 MINNEHAHA AVE, STE 130 #11, MINNEAPOLIS, MN 55406
(612) 505-2602
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MQG801650501
—
MN
Enumeration date
05/15/2026
Last updated
05/15/2026
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