| Ole Verni Shepherd, PA | |
| 
					710 S Kenwood Ave, Moose Lake, MN 55767-9405  | |
| (218) 485-4481 | |
| Not Available | 
| Full Name | Ole Verni Shepherd | 
|---|---|
| Gender | Male | 
| Speciality | Physician Assistant | 
| Location | 710 S Kenwood Ave, Moose Lake, Minnesota | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1659318228 | NPI | - | NPPES | 
| 292820500 | Medicaid | MN | |
| 41966500 | Medicaid | WI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363A00000X | Physician Assistant | 1517-023 (Wisconsin) | Secondary | 
| 363A00000X | Physician Assistant | 8988 (Minnesota) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ole Verni Shepherd, PA Rr 2 Box 196, St James, MN 56081-9653 Ph: (507) 327-7698  | Ole Verni Shepherd, PA 710 S Kenwood Ave, Moose Lake, MN 55767-9405 Ph: (218) 485-4481  | 
Mr. Nathan Wayne Gilbertson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4570 County Highway 61, Moose Lake, MN 55767 Phone: 218-485-4491  | |
Ms. Gabrielle Lea Stenson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4572 County Road 61, Moose Lake, MN 55767 Phone: 218-785-2015  |