Individual
AMY LYNN HUSEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6490 EXCELSIOR BLVD, STE W200, ST LOUIS PARK, MN 55426-4705
(952) 993-3180
Mailing address
6465 WAYZATA BLVD, SUITE 210, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9774
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876443300
—
MN
Enumeration date
12/16/2005
Last updated
07/17/2009
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