Individual
TUCKER A SHELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN,CNP
Contact information
Practice address
415 BARCLAY AVE, PINE RIVER, MN 56474-1603
(218) 587-4416
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7543
MN
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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