Individual
KALLI ANN SHADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 273-9400
(612) 273-9400
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
09/11/2016
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