Individual
LESLIE ANUNCIACION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4670 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-4119
(952) 993-4999
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12208
MN
Other
Enumeration date
09/14/2016
Last updated
01/09/2025
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