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General NPI Number Information
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NPI Number | 1104647395
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Entity Type | Individual
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Provider Name | CALIE SHEMWELL CNP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1200 LAGOON AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-2077
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Country | US
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Telephone | 888-251-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 PINE ST W
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City | STILLWATER
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State | MN
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Zip | 55082-5647
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Country | US
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Telephone | 952-334-2173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 12151
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License Number State | MN
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