| Doctor Name: | JORI L SHORE |
| NPI Number: | 1013994532 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 9596 |
| Business Practice Address: | 1885 Plaza Dr Park Nicollet Clinic - Eagan Eagan, MN - 551222612 |
| Business Phone Number: | 9529934001 |
| Business Fax Number: | 9529934075 |
| Mailing Address: | 6465 Wayzata Blvd, Ste 315 ST LOUIS PARK |
| State: | MN |
| Postal Code: | 554261728 |
| Phone Number: | 9529937169 |
| Fax Number: | 9529930300 |
| NPI Enumeration Date: | 12/27/2005 |
| NPI Last Update Date: | 05/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 9596 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |