Ole Verni Shepherd, PA

NPI #1659318228 in Moose Lake, Minnesota

Provider Information

NPI Number: 1659318228
Entity Type: Individual
Name: Ole Verni Shepherd, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 1, 2006
Last Updated: May 25, 2012

Practice Location

Address: 710 S KENWOOD AVE
City: Moose Lake
State: Minnesota
ZIP Code: 55767-9405
Phone: (218) 485-4481

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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