DEBRA LYNN SHAW (NPI# 1154494029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154494029 |
| Entity Type | Individual |
| Full Name | DEBRA LYNN SHAW |
| Credential | NP |
| Practice Address |
3400 West 66th Street Suite 290 Edina MN 55435 |
| Mailing Address |
10973 233rd Ave Nw Elk River MN 55330 |
| Practice Telephone | 9529141882 |
| Practice Fax Number | 9529141727 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-01-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R144120-2 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE | 500004309 | 01 |
| MN | 6409270-00 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023146164 | Debra Kay Shaw | Nurse Practitioner | 100 N. 15th St., Suite 201, Richmond, IN 47374 | 2007-03-01 |
| 1588645832 | Debra E. Shaw | Pharmacist | 523 Main St, Coshocton, OH 43812-1628 | 2005-11-11 |
| 1336683812 | Debra Shaw | Registered Nurse | 2340 Hampton Ave, Saint Louis, MO 63139-2935 | 2016-12-18 |
| 1740687425 | Debra Shaw | Occupational Therapist | 3057 Cleveland Ave Sw, Canton, OH 44707-3625 | 2014-11-25 |
| 1568890283 | Debra Ann Shaw | Massage Therapist | 263 State St, Suite 6, Bangor, ME 04401-5435 | 2013-10-15 |
| 1992991590 | Debra E. Shaw | Counselor | 11 Mill St, Houlton, ME 04730-1877 | 2007-09-18 |
| Street Address |
3400 WEST 66TH STREET SUITE 290 |
| City | EDINA |
| State | MN |
| Zip Code | 55435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912456716 | Phylicia Binotto | Nurse Practitioner | 3400 West 66th Street, Suite 290, Edina, MN 55435 | 2016-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154887214 | Shannon Greaves | Nurse Practitioner | 6565 France Ave S Ste 101, Edina, MN 55435-2154 | 2019-02-13 |
| 1417374729 | Alisha Englund | Nurse Practitioner | 5901 Lincoln Drive, Cbc-ehs-2, Edina, MN 55436 | 2014-03-25 |
| 1215095435 | Kristie J Anderson | Nurse Practitioner | 6905 York Ave S, Edina, MN 55424 | 2006-12-04 |
| 1861483257 | Diana Brooke Czel | Nurse Practitioner | 6545 France Ave S Ste 210, Edina, MN 55435-2281 | 2005-11-03 |
| 1598759193 | Christina Marie Braatz | Nurse Practitioner | 7505 Metro Blvd Ste 400, Edina, MN 55439 | 2005-09-09 |
| 1134779853 | Vanesha Vasian Gordon-king | Nurse Practitioner | 6401 France Ave S, Edina, MN 55435-2104 | 2019-09-14 |
| 1992355937 | Amal Said | Nurse Practitioner | 7000 York Ave S, Edina, MN 55435-4213 | 2019-09-11 |
| 1225683618 | Dawn Blindauer | Nurse Practitioner | 6905 York Ave S, Edina, MN 55435 | 2019-08-03 |
| 1043793144 | Stephanie Lynae Gulbranson | Nurse Practitioner | 6545 France Ave S, Edina, MN 55435-2131 | 2018-09-13 |
| 1922585983 | Bertina Lovine Haug | Nurse Practitioner | 3400 W 66th St Ste 290, Edina, MN 55435-2133 | 2018-07-23 |
| Find all providers in EDINA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.