Individual
KATRINA REBECCA ROGAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1411 STATE HIGHWAY 79 EAST, ELBOW LAKE, MN 56531-4611
(218) 685-4461
(218) 685-6749
Mailing address
1411 STATE HIGHWAY 79E, ELBOW LAKE, MN 56531
(218) 685-4461
(218) 685-6749
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11375
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A341055895108
DRIVERS LICENSE
MN
Enumeration date
06/07/2013
Last updated
12/27/2016
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