Provider Demographics
NPI:1710677919
Name:STORLEY, CHAD SHANNON HOWES (PA-C)
Entity type:Individual
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First Name:CHAD
Middle Name:SHANNON HOWES
Last Name:STORLEY
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6099 WAYZATA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5538
Mailing Address - Country:US
Mailing Address - Phone:612-871-1144
Mailing Address - Fax:
Practice Address - Street 1:6099 WAYZATA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5538
Practice Address - Country:US
Practice Address - Phone:612-871-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2025-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN15538363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant