Individual
MISS HOLLY LYNE BEAULIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1973 SLOAN PL STE 100, SAINT PAUL, MN 55117
(651) 241-5593
(651) 241-5870
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1145
(612) 870-5491
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10419
MN
Other
Enumeration date
07/14/2008
Last updated
08/14/2018
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