Individual
MISS MEGAN ANN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2351 CONNECTICUT AVE S, SUITE 200, SARTELL, MN 56377-2477
(320) 259-1411
(320) 259-8967
Mailing address
2351 CONNECTICUT AVE S, SUITE 200, SARTELL, MN 56377-2477
(320) 259-1411
(320) 259-8967
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10442
MN
363AM0700X
Medical Physician Assistant
1135
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235399635
—
MN
01
—
P00629859
RAILROAD MEDICARE
MN
Enumeration date
06/10/2008
Last updated
02/22/2023
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