Individual
KATELYNN MAE NYBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12000 ELM CREEK BLVD N STE L70, MAPLE GROVE, MN 55369-7167
(952) 431-5330
Mailing address
12000 ELM CREEK BLVD N STE L70, MAPLE GROVE, MN 55369-7167
(524) 315-3309
(952) 431-5334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13511
MN
Other
Enumeration date
03/30/2020
Last updated
07/24/2025
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