Individual
NOUNE PETROSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
508 TENTH STREET, WORTHINGTON, MN 56187-2343
(507) 372-2921
(507) 372-1815
Mailing address
508 TENTH STREET, WORTHINGTON, MN 56187-2343
(507) 372-2921
(507) 372-1815
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9885
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132167
UCARE
MN
05
—
877938400
—
MN
01
—
P00314620
RR MEDICARE
MN
Enumeration date
10/04/2006
Last updated
04/11/2008
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