Individual ProviderGrace A ShirleyNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(407) 963-2919PECOS EnrollmentBased on the most recent information from CMS, provider Grace A Shirley 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 ID1770722670Provider TypeIndividualFull NameShirley, Grace ACredentialARNPGenderFemaleSole ProprietorYesEnumeration Date2/17/2009Last Updated6/23/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(407) 963-2919FaxUnlisted FaxMailing LocationMailing AddressPO Box 1459, Minneapolis, MN 55440-1459PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseARNP 1666002Florida