Individual
GRACE A SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(407) 963-2919
Mailing address
PO BOX 1459, MINNEAPOLIS, MN 55440-1459
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP 1666002
FL
Other
Enumeration date
02/17/2009
Last updated
06/23/2020
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