Individual
TERRA MICHELE MENKOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
900 LONG LAKE RD STE 150, NEW BRIGHTON, MN 55112-6414
(612) 213-2370
(612) 524-5571
Mailing address
900 LONG LAKE RD STE 150, NEW BRIGHTON, MN 55112-6414
(612) 213-2370
(612) 524-5571
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14042
MN
363A00000X
Physician Assistant
6912
AZ
Other
Enumeration date
09/28/2017
Last updated
12/01/2023
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