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General NPI Number Information
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NPI Number | 1225850761
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Entity Type | Individual
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Provider Name | IFRAH S SHAFIE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 5270 W 84TH ST STE 370
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1377
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Country | US
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Telephone | 952-395-5223
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Fax |
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Provider Business Mailing Address
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Address Line | 13946 W PRESERVE BLVD
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City | BURNSVILLE
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State | MN
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Zip | 55337-7728
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Country | US
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Telephone | 952-594-1062
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024086274
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License Number State | MN
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