Individual
STACY MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6350 W 143RD ST STE 102, SAVAGE, MN 55378-2890
(952) 428-0200
Mailing address
6350 W 143RD ST STE 102, SAVAGE, MN 55378-2890
(952) 428-0200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/05/2008
Last updated
11/04/2020
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