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Individual

GINA OROURKE PESCHEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
675 WATER ST, EXCELSIOR, MN 55331-3063
(952) 906-7855
(952) 470-4523
Mailing address
675 WATER ST, EXCELSIOR, MN 55331-3063
(952) 906-7855
(952) 470-4523

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9668
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16686300
MN
Enumeration date
06/04/2007
Last updated
07/08/2007
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