Individual ProviderShelly K. KeenerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(866) 799-5886PECOS EnrollmentBased on the most recent information from CMS, provider Shelly K. Keener does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1548542566Provider TypeIndividualFull NameKeener, Shelly K.CredentialNPGenderFemaleSole ProprietorNoEnumeration Date9/15/2011Last Updated6/25/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(866) 799-5886FaxUnlisted FaxMailing LocationMailing AddressPO Box 1459, Minneapolis, MN 55440-1459Phone(866) 799-5886FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2011030536MissouriProvider IdentifiersIDDescriptionIssuerID1548542566DescriptionMedicaidIssuerUnlistedMissouriID200739410BDescriptionMedicaidIssuerUnlistedKansas