Individual
SHELLY MARIE MAHOWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1611 ANNE ST NW, BEMIDJI, MN 56601-5114
(218) 333-5000
(218) 333-5880
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(218) 333-5000
(218) 333-5880
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7109
MN
Other
Enumeration date
03/18/2020
Last updated
07/06/2020
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