Individual
BROOKE ALEXANDRA STEIN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
21410 136TH AVE STE 105A, ROGERS, MN 55374-4921
(763) 515-6200
(763) 515-6202
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11856
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H400272686
—
MN
Enumeration date
08/20/2014
Last updated
02/11/2022
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