Individual
MS. SHARA J DIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4140
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0246
ND
363AM0700X
Medical Physician Assistant
PAC0246
ND
363AS0400X
Surgical Physician Assistant
PAC0246
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12329
—
ND
Enumeration date
05/20/2006
Last updated
08/06/2021
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