Individual
IVANA MARCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 BETHEL DR, SAINT PAUL, MN 55112-6902
(651) 635-1013
Mailing address
3900 BETHEL DR, SAINT PAUL, MN 55112-6902
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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