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General NPI Number Information
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NPI Number | 1275205833
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Entity Type | Individual
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Provider Name | SHELBY J. BEATTIE CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 1200 S. COLUMBIA RD
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City | GRAND FORKS
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State | ND
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Zip | 58201-4036
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Country | US
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Telephone | 701-780-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13780
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City | GRAND FORKS
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State | ND
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Zip | 58208-3780
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Country | US
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Telephone | 701-780-1891
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 203061
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 261849-30
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License Number State | WI
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