Shepherd, Ole Verni

Shepherd, Ole Verni is an individual health care provider with primary practice located at 710 S Kenwood Ave , Moose Lake MN 55767-9405. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Shepherd, Ole Verni can be contacted via phone (218) 485-4481.

Contact Information

Primary practice address
710 S Kenwood Ave Moose Lake MN 55767-9405
Phone: (218) 485-4481
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1517-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 8988 Minnesota

Profile Details

NPI number 1659318228
LBN Legal business name Shepherd, Ole Verni
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated May 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659318228 NPPES
Minnesota MEDICAID 292820500
Minnesota MEDICAID 41966500

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