| Doctor Name: | AMY JO SHINGLEDECKER |
| NPI Number: | 1114336468 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R175708-0 |
| Business Practice Address: | 1919 University Ave., Suite 130 St. Paul, MN - 55104 |
| Business Phone Number: | 6516470017 |
| Business Fax Number: | 6516473423 |
| Mailing Address: | 1919 University Ave., Suite 130, ST. PAUL |
| State: | MN |
| Postal Code: | 55104 |
| Phone Number: | 6516470017 |
| Fax Number: | 6516473423 |
| NPI Enumeration Date: | 08/11/2014 |
| NPI Last Update Date: | 08/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | R175708-0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |