Individual
JADE STORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 417-6000
Mailing address
5245 28TH AVE S APT 204, FARGO, ND 58104-9081
(605) 881-0456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0819
ND
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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