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Individual

SHELLEY R. SMEDSRUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
900 E 54TH ST N STE 200, SIOUX FALLS, SD 57104-0686
(605) 328-9556
(605) 328-9501
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0415
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6826788
SD
Enumeration date
06/21/2005
Last updated
04/18/2022
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