Individual
HAILEY GRACE SHAULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7430 WENTWORTH AVE, RICHFIELD, MN 55423-4133
(612) 488-0040
(833) 973-4055
Mailing address
1600 S WEST AVE, SIOUX FALLS, SD 57105-1441
(608) 931-7557
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13878
MN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/05/2021
Last updated
02/28/2025
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