Individual
DANIELLE NOVOTNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9974 214TH ST W, LAKEVILLE, MN 55044-1913
(952) 469-0500
Mailing address
9974 214TH ST W, LAKEVILLE, MN 55044-1913
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14351
MN
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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