Shelley Bragelman, PT
Individual provider Active NPI Physical Therapist · Mora, MN
NPI 1750798385 · NPPES record last updated Jul 15, 2014
Key facts
- NPI
- 1750798385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4940 (MN)
- Practice address
- 301 Highway 65 S
Mora, MN 55051-1899 - Phone
- (320) 225-3356
- NPI assigned
- Jul 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4940 | MN | MD | Physical Therapist |
Interoperability endpoints
- sbragelman146776@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4940 | MN | Yes |
Addresses
Primary practice location
301 Highway 65 S
Mora, MN 55051-1899
Mailing address
301 Highway 65 S
Mora, MN 55051-1899
Other providers in Mora, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.