Individual
MAGGIE VANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-7980
(651) 254-7969
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15141
MN
Other
Enumeration date
07/14/2023
Last updated
12/02/2024
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