Individual
KARISSA SORAYA SIMYAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 E 28TH ST STE H2100, MINNEAPOLIS, MN 55407-3723
(612) 863-3900
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
13087
MN
Other
Enumeration date
08/09/2019
Last updated
07/13/2020
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