Individual
MRS. SHELLY R DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
3173 43RD ST S, FARGO, ND 58104
(701) 478-8780
Mailing address
3173 43RD ST S, FARGO, ND 58104
(701) 478-8780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
3333-23
WI
Other
Enumeration date
07/03/2014
Last updated
01/21/2022
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