Provider Demographics
NPI:1457975419
Name:HAMIEL, SHAYNA (DNP, APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:HAMIEL
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:SHAYNA
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2117 PINE RIDGE RD S
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051-6821
Mailing Address - Country:US
Mailing Address - Phone:612-805-9026
Mailing Address - Fax:
Practice Address - Street 1:2117 PINE RIDGE RD S
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-6821
Practice Address - Country:US
Practice Address - Phone:612-805-9026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR170264-0163WP0200X
MN10623363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10623OtherAPRN LICENSE - CNP
MNR170264-0OtherRN LICENSE - MN