Individual
PRISCILLA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6936 PINE ARBOR DR S, COTTAGE GROVE, MN 55016-4645
(651) 326-5800
Mailing address
2004 RANDOLPH AVE, SAINT PAUL, MN 55105-1750
(651) 690-6000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/14/2026
Last updated
04/23/2026
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