Individual
MIKAELA A PENAREDONDO
Active
Individual
MIKAELA A PENAREDONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11579
MN
363AM0700X
Medical Physician Assistant
11579
MN
363AM0700X
Medical Physician Assistant
Primary
1417
SD
363AM0700X
Medical Physician Assistant
1709
NE
363AM0700X
Medical Physician Assistant
2069
MN
Other
Enumeration date
02/04/2013
Last updated
01/10/2024
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