IndividualActive
Annetta Shaw, RN,BSN,CRNFA
NPI 1770639635 · Surgical Physician Assistant · Bemidji, MN
Provider details
- NPI number
- 1770639635
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RN,BSN,CRNFA
- Sex
- Female
- Sole proprietor
- No
Practice location
3807 Greenleaf Ave Nw
Bemidji, MN 56601-5817
Phone: (218) 751-9746
Fax: (218) 759-0620
Mailing address
3807 Greenleaf Ave Nw
Bemidji, MN 56601-5817
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.