Individual
DANA B COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9364
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007T5K1
BLUE CROSS BLUE SHIELD
—
01
—
0114474
MEDICA
—
01
—
0874868
AMERICAN PPO
—
01
—
1018609
PREFERRED ONE
—
01
—
140233
UCARE MINNESOTA
—
05
—
180172400
—
MN
05
—
41920500
—
WI
Enumeration date
08/31/2006
Last updated
10/31/2016
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