Healthcare Provider Details

I. General information

NPI: 1255843249
Provider Name (Legal Business Name): SHEILA BETH KNODE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 03/04/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 1ST DR NW
AUSTIN MN
55912-2941
US

IV. Provider business mailing address

1000 1ST DR NW
AUSTIN MN
55912-2941
US

V. Phone/Fax

Practice location:
  • Phone: 507-434-1674
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number1884597
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: