Provider Demographics
NPI:1841155819
Name:SAGERHORN, SHELLY RAE (RN)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:RAE
Last Name:SAGERHORN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HIDDEN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56515-8500
Mailing Address - Country:US
Mailing Address - Phone:218-282-0490
Mailing Address - Fax:
Practice Address - Street 1:1205 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1003
Practice Address - Country:US
Practice Address - Phone:218-739-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-22
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1428445163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse