Provider Demographics
NPI:1003159377
Name:SHAPIRO, RACHEL IRIT (CPM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:IRIT
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 EXCELSIOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2703
Mailing Address - Country:US
Mailing Address - Phone:952-240-1290
Mailing Address - Fax:952-564-3262
Practice Address - Street 1:6111 EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2703
Practice Address - Country:US
Practice Address - Phone:952-240-1290
Practice Address - Fax:952-564-3262
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI143-49176B00000X
MN176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife