Individual
KENDRA NOELLE OESTREICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15075 CIMARRON AVE, ROSEMOUNT, MN 55068-1635
(651) 322-8800
Mailing address
15075 CIMARRON AVE, ROSEMOUNT, MN 55068-1635
(651) 322-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11823
MN
363A00000X
Physician Assistant
3415
CO
363AM0700X
Medical Physician Assistant
Primary
MED-PAC-LIC-901911
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16128869
—
CO
Enumeration date
07/03/2012
Last updated
12/14/2021
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