Individual
MS. KRISTI LORRAINE KOPACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
420 DELAWARE ST SE, MAYO MAIL CODE 290, MINNEAPOLIS, MN 55455-0341
(612) 625-0505
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-5790
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
837
MN
Other
Enumeration date
03/03/2006
Last updated
07/08/2007
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