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Individual

MRS. REBECCA ANN PELKOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
913 EAST 26TH STREET, TWIN CITIES SPINE CENTER PIPER BUILDING, SUITE 600, MINNEAPOLIS, MN 55404-4515
(612) 775-6200
(612) 775-6222
Mailing address
913 EAST 26TH STREET, TWIN CITIES SPINE CENTER PIPER BUILDING, SUITE 600, MINNEAPOLIS, MN 55404-4515
(612) 775-6200
(612) 775-6222

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11014
MN
363A00000X
Physician Assistant
PA17779
CA
363A00000X
Physician Assistant
PA900
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100505782
NV
01
CC7589
BCBS
NV
05
PA177790
CA
Enumeration date
11/02/2005
Last updated
03/11/2021
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