Individual
MISS MEG E. RAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1542 GOLF COURSE RD STE 204, GRAND RAPIDS, MN 55744
(218) 999-7000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13033
MN
363A00000X
Physician Assistant
2017003238
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073051926
—
MO
01
—
26-8630
MEDICARE PTAN
MO
01
—
26D0679044
CLIA
MO
05
—
PENDING
—
MO
Enumeration date
02/10/2017
Last updated
12/11/2020
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