Individual provider Active NPI

Shelly Ann Patnaude, LPN

  • Licensed Practical Nurse
  • Shakopee, MN
National Provider Identifier
1588957757
Registry record updated May 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
56815-7 Issued in MN
Practice address
752 Sarazin St
Shakopee, MN 55379-4332
Phone
(612) 382-2871
NPI assigned
May 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 56815-7 MN Primary

Addresses

Primary practice location

752 Sarazin St
Shakopee, MN 55379-4332

Mailing address

752 Sarazin St
Shakopee, MN 55379-4332
Phone (612) 382-2871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
56815-7MNMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306022400000",
    "number": "1588957757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 SARAZIN ST",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794332",
            "telephone_number": "612-382-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 SARAZIN ST",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794332",
            "telephone_number": "612-382-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATNAUDE",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-22",
        "last_updated": "2011-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "56815-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.