Individual
ERIN JOY DE LA BRUERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2720 FAIRVIEW AVE N STE 200, ROSEVILLE, MN 55113-1306
(651) 663-6883
Mailing address
16333 E LAKE NETTA DR NE, HAM LAKE, MN 55304-5126
(651) 895-7747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/17/2022
Last updated
09/07/2022
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