Basic Information
Provider Information
NPI: 1770568735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHRENS
FirstName: SHELLEY
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050001
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Practice Location
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050001
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/13/2005
LastUpdateDate: 08/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XR 134378-2MNN Nursing Service ProvidersRegistered Nurse 
363L00000XR134378-2MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X378MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home