Provider Demographics
NPI:1679899017
Name:MONNENS, SHELLY MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:MARIE
Last Name:MONNENS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 S CLIFF AVE
Mailing Address - Street 2:STE 1300
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1058
Mailing Address - Country:US
Mailing Address - Phone:605-322-8988
Mailing Address - Fax:
Practice Address - Street 1:1315 S CLIFF AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1058
Practice Address - Country:US
Practice Address - Phone:605-322-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000585363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner