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Individual

GINA SHULTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2165 WHITE BEAR AVE N, MAPLEWOOD, MN 55109
(651) 523-9800
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 523-9800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12006
MN

Other

Enumeration date
09/14/2015
Last updated
09/14/2018
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