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Individual

MEGAN MARIE LIDTKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-4568
(763) 427-9980
Mailing address
15914 LINNET ST NW, ANDOVER, MN 55304-2563

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
12/11/2025
Last updated
12/11/2025
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