Individual
RENAE MACHELLE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-4568
(763) 427-9980
Mailing address
4040 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-4568
(763) 427-9980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15482
MN
Other
Enumeration date
11/20/2025
Last updated
12/14/2025
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