Individual
STEPHANIE P ELKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
(888) 364-5977
Mailing address
267 ROMA AVE, ROSEVILLE, MN 55113-6723
(612) 236-7396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10118
MN
363AM0700X
Medical Physician Assistant
Primary
10118
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
694183400
—
MN
Enumeration date
06/27/2006
Last updated
04/30/2018
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