Provider Demographics
NPI:1285424184
Name:ROWE, SHELLY MARIE (ACUPUNCTURIST)
Entity type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:MARIE
Last Name:ROWE
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5231 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-6535
Mailing Address - Country:US
Mailing Address - Phone:612-868-0495
Mailing Address - Fax:612-868-0495
Practice Address - Street 1:1925 COUNTY ROAD B2 W STE 1
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2703
Practice Address - Country:US
Practice Address - Phone:651-631-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2087171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist