Individual
ROSALYNN VERTIZ-HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 653-2100
(651) 653-2125
Mailing address
8170 33RD AVE S- PO BOX 1309, MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 653-2100
(651) 653-2125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11431
MN
363A00000X
Physician Assistant
PA04432
TX
Other
Enumeration date
09/25/2006
Last updated
01/11/2016
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